The CQUIN payments have been reported in these pages for a long time -
WEDNESDAY, 13 JULY 2011
The Department of Health (DOH) uses a Commissioning for Quality and Innovation (CQUIN) payment framework which enables commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement goals:
"It makes a small proportion of provider income (0.5% of contract value in 2009/10) conditional on achievement of locally agreed goals around quality improvement and innovation. It is intended that goals should be stretching but realistic."
CQUIN has set targets for 2011/2012 with regard to the End of Life program.
The forward plan is to increase the number of patients identified to be on the end of life care pathway and from a baseline of 0% to 20%; it is further planned to have 30% of all patients who die in hospital dying on the Liverpool Care Pathway.
To ensure they receive their provider income in fulll, Trusts have to comply with or exceed these goals. Some, like Royal Brompton, have upped the plan expectations:
1) 95% of patients identified as end of life (last 48 hours of life for expected deaths) are offered an EOL care planning discussion
2) 80% of patients offered a discussion should have an advanced care plan
3) 98% of patients who have an advanced care plan should have a record of the decision to resuscitate stated clearly in the notes
4) 50% of patients who die in hospital (expected deaths) should die on a Liverpool care pathway
It is the DOH which is the driving force behind rolling out LCP across the NHS!
The MailOnline reports here on one of the quality schemes highlighted in the CQUIN guidance - the Advancing Quality programme in the
region. - North
The hospitals given a cash bonus if FEWER patients die
- UK trial led to 900 lives being saved over 18 months
- Fewer deaths from hip replacements and conditions such as pneumonia
A controversial scheme to give hospitals a bonus if fewer patients die has led to nearly 900 lives being saved over 18 months.
Twenty four NHS hospitals in the north west took part in the Advancing Quality programme where they are given cash incentives to cut mortality rates for conditions like heart attacks.
A total of £4.8 million over 18 months was available to share between those hospitals who showed the most improvement in their death rates.
Is there a conflict between one 'controversial scheme' to prevent death and another 'controversial scheme' to promote death, via the
care pathway? Liverpool
May both be cleverly managed and manipulated to gain funding?
Here is NHS local -
High mortality rates can be "re-coded" by describing patients' conditions as terminal, Inquiry told
Published ; updated .