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Lansley launches NHS mandate with more details of quality premium, and promises 'autonomy' for CCGs

Quality premium payments that CCGs will distribute to GP practices based on commissioning performance will be drawn from overall NHS administration costs, and not CCGs' management allowance, the Government has revealed.

The further details of how the premium will be funded are contained within the Government's draft ‘NHS mandate' for the NHS Commissioning Board, published today.

Our NHS Care Objectives: A Draft Mandate to the NHS Commissioning Board – launched this afternoon by health secretary Andrew Lansley, sets out 22 formal objectives - based on the 60 indicators in the NHS Outcomes Framework - for the NHS Commissioning Board to deliver between April 2013 to March 2015.

Ministers said the mandate would allow CCGs to operate with sufficient autonomy, but also hold the NHS Commissioning Board to account on the delivery of a series of outcome targets.

One of the 22 objectives for the Board is to ‘ensure that financial incentives for commissioners and providers support better outcomes and value for money; extend and improve NHS pricing systems so that money follows patients in a fair and transparent way that enables commissioners to secure improved outcomes'.

As part of this, it says: ‘There should be incentives for commissioners, through a Quality Premium developed by the Board, which reward them for achieving high-quality outcomes within the resources available. Funding for the Quality Premium will come from within the overall administration costs limit set in directions for the NHS commissioning system.'

Elsewhere, the mandate includes targets to extend choice, widen the rollout of personal health budgets, and ensure the new system promotes integrated care.

It also stipulates patients' rights under the NHS Constitution such as being treated within 18 weeks, and includes indicators requiring the Board to meet national aims on areas such as improving dementia care and securing additional numbers of health visitors.

It also sets out aspirational targets for improvements against outcome indicators over the longer term, to cover the next five and 10 years, that will be revised and refreshed annually.

It says clinical senates and clinical networks – which some commissioning leaders feared could hinder CCGs autonomy in making decisions - will only be ‘sources of advice', with CCGs ‘free to make their own arrangements collectively or individually'.

The mandate is centred on five broad domains in which to improve outcomes; preventing people from dying prematurely enhancing quality of life for people with long-term conditions, helping people to recover from episodes of ill-health or following injury, ensuring people have a positive experience of care, and treating and caring for people in a safe environment and protecting them from avoidable harm.

Health Secretary Andrew Lansley said: ‘In the past there has been too much focus on systems and processes rather than people. For the first time we will focus on holding the health service to account for results that make a difference to people.

‘The future of the NHS will be based on transparency, autonomy and the deep values that have seen it through six decades of change.  Parliament and the public will, like never before, be able to hold the Secretary of State and the NHS to account for what it actually does for patients. 

‘The launch of these care objectives and the consultation underlines my ambition to improve outcomes for patients and place patients right at the heart of everything the NHS does.'

The consultation on the draft proposals will run from 4 July to 26 September, with the final mandate due to be published in Autumn 2012.

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