Specialised Services Quality Dashboards
Specialised Services Quality Dashboards (SSQD) are designed to provide assurance on the quality of care by collecting information about outcomes from healthcare providers. SSQDs are a key tool in monitoring the quality of services, enabling comparison between service providers and supporting improvements over time in the outcomes of services commissioned by NHS England.
For each SSQD of relevance to a patient’s care, there is a list of agreed measures for which data is to be collected. These measures are included in a ‘Metric Definition Set’.
Healthcare providers, including NHS Trusts, NHS Foundation Trusts and independent providers, submit data for each of the agreed measures.
Each SSQD is ‘refreshed’ with up-to-date outcomes submitted from national data sources, and where necessary healthcare providers, on a quarterly basis.
The information provided by the SSQDs is used by NHS England specialised services commissioners to understand the quality and outcomes of services and reasons for excellent performance. Current specialised services quality dashboard metrics covering 52 services are now available. The focus will be on extending dashboards to cover 80% of specialised services with clinical outcome data.
Providers continue to be required to have an overall registered gatekeeper and service level lead for each dashboard, and to continue to submit data via the portal in line with information requirements.
Service Specification Compliance
The Quality Surveillance Team (QST) will work with the six Programmes of Care Boards to identify the priorities for quality indicator development, particularly where service specifications are introduced or revised.
Where indicators have not yet been developed providers will be expected to continue to self-declare (using the Quality Surveillance Information System portal), against the key requirements from the service specification compliance process. The self-declaration, annual assessment and production of service profiles underpin the service specification compliance process and signposts commissioners to where they need to work with providers to address gaps in compliance.
Providers were required to complete by 30th June 2017 the self-declaration against a defined sub-set of indicators for all specialised services they are commissioned to provide with relevant approvals signed off by the chief executive of the provider.
An annual assessment will be undertaken on services that are flagged as outliers as a result of either a declaration of non-compliance, or as a result of a flag from other data sources including local intelligence. This will be undertaken in collaboration with regional commissioners and the outcome recorded on the QSIS.
A quality profile will be generated for each specialised service delivered by any given provider, summarising information from quality surveillance and identifying national outliers. The profile is updated in real time from in-year portal provider submissions. It is also captured at given point annually, as part of the annual assessment, and reviewed by QST and regional commissioners to determine the level of quality surveillance for the following year. Where the process identifies gaps in compliance a meeting will be held between commissioners and providers that will give rise to agreed resolution actions.
Visits The annual programme of peer review visits takes into consideration the current priorities in the NHS England service review programme, services with significant compliance issues and where variation has been identified, either in quality or access.
Prescribed Services CQUIN 2017- 19
NHS England will invest almost £600m through the Specialised CQUIN scheme in the next two years. CQUIN provides dedicated targeted resources for clinical teams to deliver clinical quality improvements and drive transformational change in outcomes, and equity, using resources more effective.
Most schemes originate with National Clinical Reference Groups (CRGs), shaped by clinicians with recognised leadership expertise relevant to the services. To ensure sufficient time to deliver change, PSS CQUIN schemes are again multi-year, with most CQUINs continuing from 2016/17.
Once standards are reflected in the core contractual requirements set out in the quality schedule, information schedule and/or service specifications, it is not appropriate to incentivise compliance through a CQUIN scheme. For each scheme, an exit Plan is in place or in development to address any recurrent costs beyond the end of the scheme that are not offset by recurrent provider savings, to ensure change can be sustained.