Local health systems to be measured on new performance metrics

Documents published for clinical commissioning groups this week revealed a “new integrated oversight framework” is being developed for integrated care systems and sustainability and transformation partnerships.

While NHS Improvement and NHS England will continue to look at trust level and CCG level data, the new framework “will… reflect a population based approach to improving health outcomes and reducing health inequalities”.

The regulators said this would provide “greater focus on the performance of the local healthcare system as a whole”.

It is not clear what the new metrics will be or when the framework will be released. But the documents said the framework will be “informed by the long-term plan” so that healthcare systems can be assessed by metrics that reflect the plan’s “ambition”.

NHS England has already said its long-term plan will include a renewed focus on clinical outcomes and better integration of care.

It will also form a “key part of regular performance discussions between NHS England, NHSI and STPs/ICSs” in future.

The new framework is part of a “set of principles” NHS England and NHSI are developing to ensure they speak with “one voice” when regulating health economies, the documents added.

Last week Sir Chris Ham, outgoing chief executive of the King’s Fund, said that “mixed messages” from the two regulators were often preventing progress for ICS areas.

The documents said the pair would set “consistent expectations for local health systems” and work with STP and ICS leadership to tackle problems in individual organisations rather than “making uncoordinated national interventions”. It said this action would “stimulate the further growth of self-governing systems”.

They also introduced new CCG metrics for 2018-19.

These include providing data on how many people with severe mental health illness are receiving physical check ups; the total investment in primary care transformation; and the number of patients waiting six weeks or more for a diagnostic test. The regulators would then introduce demand management oversight to see if CCGs are saving cash in areas they said they would be able to.