Follow the money: financial incentives for CCGs

If you’re curious about what incentives might be guiding the new health system, this update from the NHS Commissioning Board provides some essential context:

“Financial incentives (quality premium) will be paid to all CCGs that improve or achieve on four national measures and three locally-agreed measures, set with Health and Wellbeing Boards. National measures include: potential years of life lost from causes considered amenable to healthcare; avoidable emergency admissions; the friends and family test; and incidence of healthcare associated infections.”

The ‘friends and family test’ is about whether individuals would recommend services to friends – in other words, a form of customer satisfaction. You can read concerns about it here, and analysis here.

‘Healthcare associated infections’ (HAI) refers to things such as MRSA, MSSA, E.coli and C.difficile (CDI). You can find out how these are tackled on NICE’s page, find out about education programs in Scotland, and read about a new web-based system for monitoring HAI, due to launch in April, on the Department of Health website.

Avoidable emergency admissions refers to the need to reduce demand on A&E services. Patients unnecessarily using A&E is reported to cost the NHS tens of millions.

‘Causes considered amenable to healthcare‘ essentially means avoidable deaths. Or, as Lancashire local authority put it: “deaths from certain causes and at certain ages should not occur in the presence of timely and effective health care.”

In addition to these four measures, money will be allocated based on a further three measures agreed locally, set with Health and Wellbeing Boards. We’ve explained those here. These boards will include CCG representatives, as well as local councillors and patient groups.

It will clearly be important to report which priorities those boards identify – and the discussions behind those (these may be recorded at board meetings), including priorities which may be proposed but not adopted.

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