GP revealed last year that the premium - a bonus payment for successful CCGs - could be worth £5 per patient, or £30,000 per average GP practice (GP, 5 September 2012).

Documents published by the NHS Commissioning Board (NHSCB) show that 37.5% of the payment will be tied to three local targets set by commissioners.

Performance on four national targets will determine whether CCGs earn the rest of the payment. These will cover reducing emergency hospital admissions, patient experience, mortality and healthcare-associated infections (see box for details).

A blueprint for the NHS in 2013/14 published by the NHSCB revealed that CCGs will be judged on 48 targets in total. The paper, Everyone Counts: Planning for Patients 2013/14, says the NHS will move increasingly towards routine services being available seven days a week.

It says clinical outcomes will play a greater part in the NHS, with hospitals and providers asked to submit data on quality of care and survival rates. Core clinical data extracted from GP practice systems will help to track outcomes.

Local CCG targets will have to be agreed with the NHSCB, health and wellbeing boards and patients. The NHSCB will decide how CCGs can spend the premium early this year. A spokesman said CCGs would be free to use it in any way that improves 'patient care and/or health outcomes'.

GPC negotiator Dr Chaand Nagpaul said the committee had lobbied for CCGs to set local targets. 'If practices incur more workload in delivering the CCG's objectives, they would have to be rewarded,' he said.

CCGs will not get the payment if they are overspent or have a 'significant quality failure' during the year.

From April, CCGs will inherit any PCT debt accrued this financial year. CCGs will have a budget of £64.7bn in 2013/14, a 2.3% rise on current PCT allocations, the NHSCB said.

NHSCB chief executive Sir David Nicholson said local control was 'at the heart of our approach'.

Quality Premium
Share of payment per target 37.5% - three local targets 25% - reduce or stabilise avoidable emergency hospital admissions 12.5% - reduce years of life lost from amenable mortality 12.5% - reduce healthcare-associated infections 12.5% - roll out Friends and Family test/improve patient experience of hospitals