West Midlands Specialised Commissioning Team CQUINs for Renal Services

1. West Midlands Specialised Commissioning TeamCQUINs for Renal Services Rob Lusuardi, Assistant Director Specialised Commissioning Team - West Midlands

2. CQUINs CQUINs: �the key aim of the CQUIN framework is to support a shift towards the vision set out in High Quality Care for All of an NHS here quality is the organising principle� Operating Framework 2009/10 To use payments to deliver real benefits for patients and improve quality Not to pay for achieving baseline national targets Value is to be 0.5% of total contract value

3. CQUIN Schemes should be: Challenging but achievable Indicators across pathways are encouraged 25% of scheme is allowed for improving data Process, interim outcome and outcome indicators can be used Demonstrate value of improvement to patients Spread and sustain innovation Achieve compliance with fundamentals of quality and safety Demonstrable clinical engagement in scheme Accurately measurable start and end points Part of PCT Quality Accounts

4. CQUINs & QUIPS in the West Midlands SCT (WM) was requested to deliver a programme of CQUINs & QUIPs for 2009/10 contracts SHA recognised need to establish robust data flows as first stage of implementation especially for specialised services SCT (WM) developed series of Quality Improvement Plans (QUIPs) Formal CQUIN schemes in 2010/11 Trusts generally supportive

5. SCT (WM) QUIP INDICATORSFOR END STAGE RENAL FAILURE QUIP This QUIP is designed to support the Renal Units in submitting all mandatory data, and in agreement with the West Midlands Renal Network support the compilation of that data and undertake benchmarking and audit with the aim of developing performance improvement targets for each provider for 2010/11 Rationale This will benefit patients by allowing commissioners for the first time to routinely benchmark and assess the clinical quality of services at each of the renal providers in the west midlands.

6. SCT (WM) QUIP INDICATORSFOR END STAGE RENAL FAILURE Approach Establish a sub-group of the West Midlands Renal Network to support the compilation of data and undertake benchmarking, audit and investigation. In conjunction and agreement with the Renal Network, key indicators will be collected which will demonstrate the adequacy of clinical performance of renal providers, and give impetus and stimulus for a greater appraisal of clinical performance. This will lead to discussion at contract review meetings which engage with clinicians as well as contract managers and commissioners.

7. SCT (WM) QUIP INDICATORSFOR END STAGE RENAL FAILURE Progress All renal units will be required to submit mandatory and defined non-mandatory data field as part of the Renal Registry returns Minimum data set to be agreed Need to establish mechanism for extracting data for the network to aggregate and report to commissioners at least quarterly Interpretation and role of network data sub-group Baseline performance will influence the level of change required to reach agreed standards at each provider � the perceived fairness of funding these improvements will be critical