Plans to expose bad care and poor patient safety are to be taken forward with a consultation on the first NHS quality framework.

The document, to be published in the coming weeks, will set out measures for comparing quality across the service.

NHS medical director Sir Bruce Keogh is expected to identify a set of priority outcome indicators to be reported nationally.

Further indicators will be defined for regional and local managers to use for performance management, commissioning and assurance.

Some results will be published on the NHS Choices website, along with mortality rates for knee and hip replacements and emergency and elective abdominal aortic aneurysm repair, which have been on the site since July.

Blunt measures

At a meeting organised by the National Confidential Enquiry into Patient Outcome and Death in London last week, Sir Bruce admitted these were a "blunt measure" designed to kick-start the debate about what information to give patients to aid choice. He said the next wave of indicators would be developed by the professions.

"I don't yet know what they will be," he said.

"There is no point in me as medical director producing thousands of metrics. What I want is to kick-start a serious discussion within professional circles and among professional organisations on how we use currently available data and then how we start to move into more sophisticated measures."

Quality framework

Sir Bruce said he and chief nursing officer Christine Beasley were about to launch a consultation, to be led by the professions, on a range of measures proposed by trusts. The quality framework is expected to be composed of measures in three domains (safety, patient experience and outcomes and effectiveness) and of three types (structure, process and outcomes indicators).

Department of Health strategy unit deputy director and head of customer insight Chris Heffer said the framework covered acute care but may be developed for primary care in the future.

Work was also being taken forward on patient-reported outcome measures, with methods of recording patients' experience being developed to give better insight into care pathways. Mr Heffer told an HSJ conference last week that this was not currently measured as data focused on single services, while pathways cut across sectors.

  • Sir Bruce has also revealed the DH is planning to appoint a "trauma czar". The successful candidate will co-ordinate the 10 trauma plans already in place in the strategic health authorities.

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