National Institiue for Health and Clinical Excellence

Annual Review - 2012/2013

Quality, Innovation, Productivity and Prevention

The Quality, Innovation, Productivity and Prevention (QIPP) Collection highlights examples of local practice, which demonstrate how NHS and social care organisations have implemented initiatives that have improved quality and/or made efficiency savings.

It is intended to be a resource for everyone in the NHS, public health and social care for making decisions about patient care or the use of resources, which will help organisations to meet the QIPP challenge to save £20bn by 2015.

The collection includes case studies drawn from local submissions, and from Cochrane reviews.

  • QIPP case studies cover a wide variety of topics that have been submitted from NHS, public health or social care organisations across the UK. They are examples of how health and social care staff are improving quality and productivity in their own organisations.  Case studies are evaluated based on quality improvements and savings and provide evidence and information about implementation. These case studies are peer reviewed.
  • Cochrane quality and productivity topics are drawn from systematic reviews by the Cochrane Collaboration and provide evidence for disinvestment.

By the end of March 2013, the collection included 126 case studies. This included 25 new case studies which were added during 2012/13 and 16 updated case studies.

Submissions to the collection can involve private organisations but must be owned by an NHS organisation/local authority which has actually implemented the initiative.

Publications are then categorised either as proposed or proven, depending upon the evidence of change which is available upon submission.

In order to continually raise awareness of new QIPP initiatives, links to all published case studies are emailed to a growing list of stakeholders as part of a monthly e-shot. Summaries of new initiatives are tweeted to followers of NICE on Twitter, information is circulated to a number of networks, and regular features appear in our newsletters Eyes on Evidence and NICE News.

A QIPP case study: Musculoskeletal physiotherapy and patient self-referral

In February 2013, the Department of Health's Any Qualified Provider (AQP) guidelines for musculoskeletal services were changed to recommend patient self-referral, after consideration of the 2012 QIPP case study from the Chartered Society of Physiotherapy.

As well as giving patients more choice and a shorter recovery time, self-referral is a cheaper way of receiving musculoskeletal care. Self-referral, compared with traditional medical referral, results in significant NHS and patient-related benefits. Benefits to the NHS include reduced investigations, prescribing and cost of medical consultation, without any increase in physiotherapy contact numbers (Department of Health 2008).

The Chartered Society of Physiotherapy case study showed that people could self-refer to NHS (largely musculoskeletal) physiotherapy services, rather than waiting to be referred by their GP or healthcare practitioner and included input from a health economist who considered the savings and the evidence of change.

Ruth ten Hove, Professional Adviser at the Chartered Society of Physiotherapy, said: "We are delighted that the AQP guidelines have been revised in view of our latest case study which is included in the NICE QIPP collection.

"It is really positive to have this case study published and we are pleased that we can also now say we have examples of services where commissioners have reversed their decisions on self-referral because of the QIPP submission."

There were 25 new QIPP case studies added to the collection in 2012/13, as well as 16 updated case studies