National Institiue for Health and Clinical Excellence

Annual Review - 2012/2013
Quality indicators

Measuring the quality and outcomes of healthcare

In August 2012, NICE published the first set of indicators for consideration for the Clinical Commissioning Group Outcomes Indicator Set (CCG OIS) covering topics such as stroke, diabetes, and maternal health.

The CCG OIS, formerly known as the Commissioning Outcomes Framework or COF, is being developed by NHS England with support from NICE and the Health and Social Care Information Centre.

The aim is to support clinical commissioning groups (CCGs) and health and wellbeing partners in improving health outcomes by providing comparative information on the quality of health services commissioned by CCGs and the associated health outcomes – and to support transparency and accountability by making this information available to patients and the public.

In total, a set of 44 indicators were recommended by the CCG OIS Advisory Committee - established to oversee this work - for consideration by NHS England for inclusion in the 2013/14 indicator set.

Professor Danny Keenan, CCG OIS Advisory Committee Chair, said: "The broad range of clinical expertise within the independent committee, including GPs, hospital doctors, patients and commissioners, ensures that the menu of CCG OIS indicators recommended are workable, and can help improve the quality of commissioning to benefit patient care.

"We're pleased to recommend this robust set of indicators for potential inclusion in the first CCG OIS, and hope that they will help the new commissioning groups to secure NHS services for their populations that will lead to improved health outcomes."

NHS England accepted 34 of NICE's recommendations and published the CCG OIS for 2013/14 in December 2012.

In January 2013, 32 new indicators were consulted on for consideration for the CCG OIS for 2014/15, with a broad range of new topics including cancer, chronic heart failure and mental health. These will be considered further during 2013/14.

Driving up patient care in general practice

Introduced in 2004, the Quality and Outcomes Framework (QOF) is an incentive scheme for GP practices in the UK, rewarding them for how well they care for patients.

NICE has been involved in developing clinical indicators for the QOF since 2009, following calls for a more independent and transparent process for reviewing and developing indicators.

In August 2012, NICE published its recommendations for proposed indicators and the retirement of a number of existing indicators for the 2013/14 QOF.

NICE recommended that rheumatoid arthritis (RA) be added to the QOF for the first time. Four indicators covered practices producing a register of all patients aged 16 years and over with RA, assessment of cardiovascular risk and fracture risk and an annual face to face review.

NICE also recommended an indicator on cancer that incentivises practices to review patients with a new diagnosis of cancer within 3 months of the practice receiving confirmation of the diagnosis.

Other proposed indicators covered diabetes, heart failure, COPD hypertension and depression.

A number of existing indicators were also proposed to be retired or amended, including ones for coronary heart disease, chronic kidney disease, epilepsy and hypertension.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "These QOF indicators can make a real difference, helping to ensure high standards of care and improve outcomes for patients in general practice.

"These indicators are based on the best evidence and have been subject to wide consultation with professional groups, patients and community and voluntary organisations, as well as being tested across general practice to make sure they work.

"The independent QOF Advisory Committee has carefully considered the indicators before recommending them for inclusion in this final menu, and we believe that indicators on these aspects of healthcare will help contribute to high quality outcomes for patients."

The CCG OIS will help the new commissioning groups to secure NHS services for their populations that will lead to improved health outcomes