Local CCG quality premium targets worth £11,250 for practices

The three local measures in the CCG quality premium for England, worth up to £30,000 per average practice, will make up 37.5% of its total to CCGs.

The most valuable target is reducing avoidable emergency admissions.

Further draft guidance on how the quality premium is expected to work from April 2013 was published by the NHS Commissioning Board (NHSCB) on Friday.

Quality Premium: 2013/14 guidance for CCGs Draft – December 2012 reveals more detail of the four national indicators also and how much they are worth.

* The most valuable is reducing avoidable emergency admissions (25%). To earn this portion of the quality premium, there will need to be a reduction or 0% change in emergency admissions for these conditions for a CCG population between 2013/14 and 2014/15.

* Reducing potential years of lives lost through amenable mortality is worth 12.5%. To earn this portion of the quality premium, the potential years of life lost (adjusted for sex and age) from amenable mortality for a CCG population will need to reduce by at least 3.2% between 2013 and 2014.

* Ensuring roll-out of the Friends and Family Test and improving patient experience of hospital services is worth 12.5%. To earn this portion of the quality premium, there will need to be assurance that all relevant local providers of services commissioned by a CCG have delivered the nationally agreed roll-out plan to the national timetable; and an improvement in average scores for acute inpatient care and A&E services between quarter 1 2013/14 and quarter 1 2014/15 for acute hospitals that serve a CCG’s population.

* Preventing healthcare-associated infections is worth 12.5%. A CCG will earn this portion of the quality premium if there are no cases of MRSA bacteraemia for the CCG’s population and C. difficile cases are at or below defined thresholds for CCGs.

The guidance adds that local measures should be agreed ‘with the NHS Commissioning Board after consideration with health and wellbeing boards and key stakeholders, especially patients and local community representatives’.

The NHSCB reserves the right not to make any payments in cases of serious quality failure.

A CCG will not receive a quality premium if it has failed to manage within its total resources.

A quality premium will be reduced if providers do not meet the NHS Constitution requirements for the following patient rights or pledges:

* patients on incomplete non-emergency pathways (yet to start treatment) should have been waiting for no more than 18 weeks from referral;

* patients should be admitted, transferred or discharged within four hours of their arrival at an A&E department;

* maximum two-month (62-day) wait from urgent GP referral to first definitive treatment for cancer;

* category A red 1 ambulance calls resulting in an emergency response arriving within eight minutes.

Where a CCG does not deliver the identified patient rights and pledges on waiting times, a reduction of 25% for each relevant NHS Constitution measure will be made.

The quality premium payment will be made in 2014/15.

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