NICE has revealed the final list of targets in eight areas that it recommends the quality premium for GP practices is tied to, which include mortality for cancer and respiratory disease and patient experience of GP out-of-hours services.
The list of areas CCGs are likely to be assessed on also includes reducing the number of people with dementia on antipsychotics, emergency admissions for conditions that do not normally require hospital admission and the proportion of patients ‘feeling supported to manage their own condition’.
The Commissioning Outcomes Framework (COF) has been developed by the NHS Commissioning Board and NICE, and forms the basis of how the performance of CCGs will be assessed. This performance will dictate the quality-premium payments made to GP practices.
A statement from NICE says: ‘The COF will allow the NHS Commissioning Board to identify the contribution of CCGs to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.
‘It will also enable CCGs to benchmark their performance and identify priorities for improvement.’
Commenting on the new indicators, GPC Chairman Laurence Buckman said: ‘Some of the indicators are more problematic than others. Many are population dependent, for things that GP’s or commissioners can’t influence.’
‘But we will work with the Government to make these indicators as good as they can be under the understanding that the basis for which they are collected- the linking to financial targets- are wrong. These are NICE’s suggestions not the law, and we are happy to consider NICE’s suggestions.’
Dr Peter Holden, a negotiator for the GPC said: ‘These indicators sound like political sound-bitery, with ministers saying what people want to hear. The Government says ‘We want localism’ but, within a fixed cost envelope, tell us what to spend on. It’s all very well putting these things into the framework, they have to resource it.’
‘Clearly one wants to see good care. But what’s not understood is that a patient with skin cancer probably damaged their mole 60 years ago and we can’t undo that damage with rules for outcomes.’