Trusts are improving the patient experience in areas where they receive financial incentives while neglecting others, a study suggests.
Commissioning for quality and innovation payments can cost providers up to 1.5 per cent of their income if services are not delivered to a specific standard. A study by consultancy MHP Health Mandate looked at CQUIN payments for patient experience in London and found a weak correlation between them and the results of the Care Quality Commission’s inpatient survey.
The study said: “This is surprising given that the data from the CQC inpatient experience survey is used to inform performance against the patient experience CQUIN. It suggests that some trusts are prioritising those areas of patient experience for which they are paid the quality premium, over those where they are not.”
Using data from the 2010 CQC survey and 2010-11 CQUIN payments, it found North Middlesex University Hospital Trust had achieved all its patient experience CQUIN payments while getting a score in the bottom quartile of the CQC survey.
Conversely, the Royal National Orthopaedic Hospital only received 80 per cent of its patient experience CQUIN payment while scoring in the top quartile with the CQC.
There was also a poor correlation between patient experience CQUIN and the national cancer patient experience survey. A comparison showed many London trusts that were scoring top marks with CQUIN performed poorly in the survey.
The study said: “It is possible that the overall patient experience reported by a provider may not fully reflect the particular challenges faced by specific services or specialisms.
“This would appear to be the case for London in relation to cancer services, where patients report an experience significantly worse than in other areas of the country, but nonetheless providers were able to secure a large proportion of CQUIN payments.”
Commissioning for quality and innovation is set to become more important in 2012-13 as the proportion of contract payments covered by it rises to 2.5 per cent.
The payments are made on national criteria in two areas: venous thromboembolism safety and patient experience. Other CQUINS are set at regional and local levels.
The study found in 2010-11 a total of £21.9m was withheld from London providers under CQUIN rules, 23 per cent of the money covered by the scheme.
It pointed out that this amounted to less than 0.33 per cent of their £8bn income.