Performance & Quality

Priorities for quality improvements

NHS Cambridgeshire is setting the priorities for quality improvements with all providers. As part of the contracting process NHS Cambridgeshire as the coordinating commissioner for Cambridge Universities Hospitals Teaching Trust and Hinchingbrooke Healthcare has reached agreement on quality metrics for patient safety, clinical outcomes and clinical effectiveness, user experience and innovation.

In the first year provider trusts have given priority to set up the necessary information systems and robust processes, through which they will be able to benchmark and to record these measures.

Identifying outcome metrics

NHS Cambridgeshire has identified key outcome metrics for the requirements of World Class Commissioning. Building on the key outcome metrics in the PCT strategy, our priorities will need to include referrals into smoking cessation services, long term conditions, indicators on the care of elderly and frail individuals, particularly those with dementia in the last year of life. Local organisations have also highlighted the importance of services for people with learning disabilities, and the importance of nutrition in hospitals.

Considering the performance on national quality metrics, our priorities will also include patient safety, prevention of stroke and stroke services, improving outcomes for certain cancers, and safeguarding children and vulnerable adults.

The Joint Strategic Needs Assessments and the Director of Public Health Annual Report illustrate the importance of improving prevention programmes for individuals at all stages of life. Therefore our quality monitoring will also consider the partnership agreements with local government and partner organisations, particularly in the context of the Local Area Agreement.

Like other NHS organisations, NHS Cambridgeshire has a responsibility to provide efficient and effective services which meet the needs of the thousands of people who require NHS care and treatment each year in Cambridgeshire.

The services we provide are monitored locally and at a national level through a series of performance indicators such as waiting times, quality standards and key public health targets. The Care Quality Commission (CQC), an independent body, awards annual ratings to each NHS organisation via the Periodic Review.

World Class Commissioning (WCC)

The world is changing rapidly. People are living longer, their lifestyles and working patterns are changing as they adapt to the pace and demands of their home and working environment and their aspirations for health care are changing. The NHS must be able to respond effectively and ensure that services are flexible, personalised and do not compromise on quality and safety.

There are three key initiatives which set the scene for local long-range planning of services:

• The Next Stage Review of the NHS by Lord Darzi
• The launch of World Class Commissioning by the Department of Health
• The launch of Towards the best, together by NHS East of England, which brings together the collective clinical and managerial expertise of the region to present a new vision for clinical services in the East of England.

World Class Commissioning is a new, ground-breaking approach. It takes best practice from this country and from health systems around the world to help Primary Care Trusts to commission services in the most effective way and more closely matched to local needs. It will result in better quality of care, improved health and well-being and a reduction in health inequalities across the community.

An integral part of the World Class Commissioning programme is the development of a five year strategic plan. NHS Cambridgeshire launched its Five Year Plan in March 2009 with a three month period of public consultation. We have asked local people, local community and business leaders and health professionals if we have got it right. As we develop the plan over the next five years, we shall continue to ask people if we’ve got it right.

For more information on our Five Year Plan

The Periodic Review

Up to 2008/09 the Periodic Review (previously known as the Annual Health Check) was carried out annually by the Care Quality Commission (CQC).

The CQC is an independent body charged by the Government with assessing and reporting on the performance of healthcare providers and commissioners.

In 2008/09 the Periodic review combined an organisational self assessment on a series of NHS Core Standards, two sets of targets and indicators of performance (known as Existing Commitments and National Priorities), together with information on the quality of financial management.

The rating for NHS Cambridgeshire in 2008/09 was reported as ‘Fair’ for Quality of Commissioning and ‘Fair’ for Quality of Financial Management. The Quality of Commissioning category includes the assessment against Core Standards and performance against Existing Commitments and National Priorities. The 2008/09 report can be accessed at NHS Care Quality Commission Ratings 2009.
The CQC is reviewing its methodology for the Periodic Review and annual assessments of NHS Trusts. The key Commissioner performance data collected by the CQC for 2009/10 is contained in the Vital Signs data. This shows NHS Cambridgeshire benchmarked against East of England SHA averages and England averages and where available the PCT’s performance from last year. There has been much improvement in many areas. Areas where we are below the England average are being addressed through ongoing work plans.