using cquins to improve copd care on discharge from acute trust
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Using CQUINS to improve COPD care on discharge from Acute Trust. Dr Vince Mak Consultant Physician – North West London Hospitals Clinical Lead in Respiratory Medicines Management – NHS London. What is CQUINS?. Commissioning for Quality and Innovation payment framework since 2008 - PowerPoint PPT PresentationTRANSCRIPT
Using CQUINS to improve COPD care on discharge from Acute Trust
Dr Vince MakConsultant Physician – North West London HospitalsClinical Lead in Respiratory Medicines Management – NHS London
What is CQUINS?
• Commissioning for Quality and Innovation payment framework since 2008
• A form of QoF for Providers – except payment is of money that the Provider has already earned
• Provider has to prove it has reached a level of quality before payment made
Monetary Value of CQUINS
• 2011/12 –worth 1.5% of total Provider yearly outturn (Up 0.5%)
• For NWLH = 1.5% of £250million = £3.75million
• 0.3% is allocated to the 2 National CQUINS leaving 1.2% for locally negotiated goals
National CQUINS
• 2 Obligatory National CQUINS– VTE Assessment– Improving Patient Experience
• VTE target is set at 90% of all eligible patients
• Patient experience goal is locally negotiated
Local (Regional) CQUINS
• Explicit requirement on commissioners to collaborate in order to agree a single CQUIN scheme per provider
• Each scheme has to have the National plus any number of locally agreed CQUINS from a local “Pick List” determined by SHA
What is a Local CQUIN?• CQUIN Goals should be agreed between commissioners and
providers, with clinical engagement locally, and should reflect both local priorities and priority areas
• Each CQUIN goal must be measurable, using a defined indicator
• The number of goals and indicators included within a CQUIN scheme should be determined locally to ensure that improvement is focused appropriately and that the scheme is not unnecessarily complex
COPD Discharge Bundle
• Produced by CHLARC NW London
• Care Bundle applied to all patients admitted with known COPD as a primary diagnosis
• 5 evidenced based interventions that known to improve quality of care and reduce readmissions and further exacerbations
What is CLAHRC?
• CLAHRC NW London (Collaboration in Leadership and Applied Health Research and Care
• Alliance of academic and healthcare organisations working to develop and promote a more efficient, accelerated and sustainable uptake of clinically innovative and cost-effective research interventions into patient care
• Part of National Institute of Health Research
5 Key Elements of COPD Discharge Bundle
• Smoking Cessation• Assessment for Pulmonary Rehabilitation• Disease Education and formulating self management
plan with prescribed rescue pack• Check of adequate inhaler technique by competent
trainer• Adequate Follow up arrangements made (either
community, Hospital OPA or GP)
Discharge Bundle April 2011Final
Discharge bundle as a CQUIN
• On NHS London Pick List (of 10)• Taken up by at least 4 Acute Trusts within
London so far• Target is 75% of all COPD admissions in first
year will have bundle completed by discharge• 90% in second year
Monetary Value of COPD CQUIN
• In NWLH Trust – 1.2% of outturn = £3million (0.3% allocated to National CQUINS)
• 3-4 local CQUINS chosen (including falls assessment, patients assessed within 12 hours of admission)
• Value = £0.75-1million per CQUIN
Outcome
• Acute Trusts motivated to perform (£1 million!!!!!)
• Patients get ideal care, improved QoL and reduced readmissions
• Should significantly reduce expenditure for COPD
• Good example of QIPP