NHS 'blueprint' reveals GP commissioning and quality premium targets

Clinical commissioning groups (CCGs) will be judged on 48 targets including death rates, a blueprint for the NHS reveals, and face four key targets to earn controversial quality premium payments worth up to £30,000 per practice.

DH: targets for commissioners revealed

CCGs will be judged on 48 measures of care including death rates and emergency hospital admissions, according to a blueprint for the NHS from 2013/14 published today by the NHS Commissioning Board (NHSCB).

It marks the start of a move towards a seven-day NHS, a bigger role for patient feedback, a greater focus on clinical outcomes, and more widespread data collection, including from general practice.

CCGs will share £64.7bn in funding in 2013/14 - a 2.3% rise for every group compared with current PCT budgets.

The blueprint also gives the first details of the quality premium, the controversial financial reward for good commissioning.

The BMA said it was concerned about several proposals under the 'extremely ambitious' plan.

Increased scrutiny
Under the NHSCB guidance, Everyone Counts: Planning for Patients 2013/14, CCGs will be judged against 48 indicators of care across five areas. These are: premature death, quality of life, recovery, patient experience, safe environment and protection against avoidable harm.

Targets include antipsychotic prescribing rates and patient experience of GP out-of-hours care, meaning practices are likely to face renewed scrutiny from their CCGs in these areas.

The quality premium will see CCGs paid an extra sum based on their performance against four measures, including preventing unnecessary deaths, avoiding hospital admissions, patient feedback, and care-acquired MRSA and C. difficile infections. Three local priorities chosen by each CCG will also be measured as part of the payment.

The NHS will move towards routine services being available seven days a week. National medical director Sir Bruce Keogh will lead the work, looking first at diagnostics and urgent and emergency care.

Clinical outcomes will play a greater part in the NHS, the NHSCB said, with hospitals and providers required to submit data on quality of care and survival rates. This includes collection of 'core clinical data' from GP practice systems to track outcomes throughout care pathways.

All patients will be able to give feedback in real time by 2015. This will include roll-out of the 'friends and family test' - whether patients would recommend the service to a close friend or relative - first to hospitals and then to other providers, potentially including GP practices.

BMA chairman Dr Mark Porter said: 'Today’s guidance is an extremely ambitious plan for the NHS in England, particularly at this time of major structural change and continuing financial pressure. While many of the aims are laudable, new CCGs will have the very real challenge of putting these aspirations into practice.'

He said although the BMA supports better information for patients, 'basic mortality figures alone could mislead patients because they fail to take into account other factors that might have contributed to the death of a patient'.

Dr Porter also repeated concerns that the quality premium may disadvantage CCGs in more deprived areas, potentially worsening health inequalities.

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