New incentives to improve patient safety have been outlined by NHS England. These include advances in seven day services, care of sepsis and acute kidney injury, as well as moves to tackle antibiotic resistance.

The planning guidance for clinical commissioning groups and NHS providers published last month set out the national officials’ priorities for clinical improvements for 2015-16.

All acute providers will need to agree service delivery and improvement plans with their commissioners setting out how they will make progress over the next 12 months on implementing the rollout of seven day services.

In 2015-16 providers will need to meet at least five of the 10 clinical standards for seven day services published by NHS England in December 2013.

The document, which was jointly published by NHS England, Monitor and the NHS Trust Development Authority, says additional funding will be available to do this, and adds: “We recognise that the tariff for 2015-16 does not include specific additional resources for seven day working.”

Two new clinical priorities identified for the 2015-16 financial year will be improving the care of patients with sepsis and acute kidney injury.

Sepsis, when the body’s immune response to an infection attacks healthy organs, kills around 37,000 people a year. Acute kidney injury is linked to up to 100,000 deaths in secondary care each year, with a quarter estimated to be preventable.

New boards to oversee forward view vision

Three new boards will support the health service as it moves towards the new care models set out in the NHS Five Year Forward View.

Under the 2015-16 planning guidance the new models of care board, co-chaired by NHS England, will oversee the process to choose the first “vanguard” health economies that can develop “prototypes” of the new models.

Health economies that are seeking to be at the forefront of moving to the new models of care – such as primary and acute care systems and multispecialty community providers – have until 2 February to submit an expression of interest to NHS England.

A new national advisory board with a system-wide coordination role for workforce issues will also be created, and chaired by Health Education England.

It will develop new workforce models and support the wider system as it moves towards the new care models.

The guidance also reveals plans for a “revitalised” national quality board to “provide collective leadership for quality across the system”.

This board will review the quality of care in the NHS using Care Quality Commission inspections and identify barriers to improvements.

 

NHS England believes improving care in these two areas will have the biggest effect on reducing premature mortality and both conditions will be national indicators within the commissioning for quality and innovation payment framework, which links providers’ income to improvements.

Ahead of national guidance on urgent and emergency care, which the document said will be published in the summer, CCGs and hospital trusts will also be expected to “prioritise the major strategic and operational task” of how to implement changes flowing from the ongoing national emergency care review.

NHS England will include incentives in both CCG quality premiums and the CQUIN framework to drive this work. Under the former, CCGs will receive additional funding based on a set of indicators.

The guidance adds: “Urgent and emergency care networks, which will build upon existing system resilience groups, should be established by April 2015, and oversee the planning and delivery of a regional or sub-regional urgent care system. This will include designating and then assuring the quality of urgent care facilities in line with guidance planned for summer 2015.”

To help tackle the growth in antibiotic resistant bacteria CCGs, together with providers, will be expected to develop plans to improve antibiotic prescribing in primary and secondary care.

The guidance says: “CCGs should ensure that secondary care providers validate their antibiotic prescribing data following the Public Health England validation protocol. This forms the basis of a new national quality premium measure for CCGs in 2015-16.”

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