2009-10 Operating Framework and Standard NHS Contracts
In December 2008 The DH published the Operating Framework for 2009/10, alongside the allocations for PCTs for the next two years and the new Standard Contracts to be used for commissioning mental health & learning disability services, community services and ambulance services.
The PCT Network has produced a simple easy reference list of 75 requirements for action for PCTs which are contained with the Operating Framework. For more information, please contact david.stout@nhsconfed.org
We have also published a Briefing paper highlighting some of the key elements of the new Standard NHS Contracts that commissioners should be aware of.
Commissioning for Quality and Innovation (CQUIN)
The Commissioning for Quality and Innovation (CQUIN) framework is designed to encourage organisations to focus on quality improvement and innovation in commissioning discussions. The CQUIN payment framework was introduced in the standard NHS contracts for the first time this year. For the acute sector, CQUIN schemes link payment to specific locally determined goals. In community, mental health and ambulance services PCTs and providers have the option of developing a CQUIN scheme or linking payment to an agreed quality improvement plan. However, this option is only available in 2009/10 as an interim stage. From 2010/11, all organisations will need to develop CQUIN schemes, and should be moving towards agreeing goals that reflect measured improvements in performance on quality.
The DH has produced a provisional review of the use of CQUIN schemes in 2009/10. It is based on an analysis of 215 schemes representing 60% of providers on standard NHS contracts, and describes the scope and nature of CQUIN schemes as they have been developed across the country.
To help share further information on how CQUIN is being implemented and what is working well, commissioners are encouraged to publish their schemes on the NHS Institute’s PCT Portal. Visit the Portal to see examples of CQUIN schemes that have been agreed in other areas and to share your own.
You can read the CQUIN Review in full here. For further information, or to provide feedback on your expereinces of implementing CQUIN please contact Elizabeth Wade at Elizabeth.wade@nhsconfed.org or on 020 7074 3215.
Payment by Results
The Department of Health is currently developing a number of "Best Practice Tariffs", following a commitment in High Quality Care for All. The project
will look at how the national tariff price and structure can be used to
reduce the barriers to high quality care in a number of high volume areas.
For 2010/11 the focus will be on tariff structure and a variety of
approaches will be tested. These include payment for pathways rather than
spells of activity or targeted payments for certain procedures (e.g. CT
scans).
Looking beyond 2010/11, work will start to concentrate on using
bottom-up costing to inform the national tariff. There will be attempts
to move away from using national average reference costs to set tariff
price.
The project is being managed by the Payment by Results team. The team is
seeking involvement from colleagues in PCTs in the development phases. The
team is planning to hold some events later in the year to discuss the
suggested approaches already being developed, as well as the scope of Best
Practice Tariffs beyond 2010/11. In the meantime, the team would like to
hear from commissioners with either specific interest or who are delivering
good practice or innovative commissioning in any of the five service areas
included in the project (cataracts, cholecystectomy, renal dialysis, hip
fractures and stroke).
For further information about the Best Practice Tariffs project please see the attached briefing.
To feed back your comments or if you would like to be involved, please contact the PbR team at the DH at pbrcomms@dh.gsi.gov.uk.
HRG4 – Expert Reference Groups
The Information Centre is looking for PCT commissioning representatives to sit on the Expert Reference Groups for the different HRG chapters. Your background could be finance, information or commissioning with an understanding of the practical implementation of payment by results.
For more information on the roles see the terms of reference and roles description or contact Andrew Hall at the Information Centre at andrew.hall@ic.nhs.uk
Revised code to govern Payment by Results conduct
The Department of Health DH has published the latest version of the Code of Conduct for Payment by Results. This is the fourth version of the code and will be implemented from 1 April. It reflects the new developments in the national tariff and the introduction of HRG 4.
The PCT Network is represented on the National Payment by Results (PbR) Programme Board by John McIvor, Chief Executive of Lincolnshire PCT and David Stout. The Network has also had input into the PbR Technical Group.