2013/14 NHS STANDARD CONTRACT FOR ACUTE, AMBULANCE, COMMUNITY AND MENTAL HEALTH AND LEARNING DISABILITY SERVICES NHS Standard Contract 2014/15 CQUIN Barnet, Enfield & Haringey NHS Mental Health Trust . Particulars – DS39 2013/14 NHS STANDARD CONTRACT 2014/15 NHS STANDARD CONTRACT PARTICULARS Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: CQUIN Schemes Goal Number Goal Name Description of Goal Friends & Family National Requirement To be confirmed To be confirmed Improving physical healthcare to reduce premature mortality in people with severe mental illness (SMI) MH1 National Requirement To be confirmed To be confirmed Effectiveness Specialised Services Quality Dashboards To be confirmed To be confirmed MH5 Collaborative Risk Assessments – Medium & Low Secure Needs Formulation at Transition – Medium & Low Secure Outcome Measures – Adult Eating Disorders To be confirmed To be confirmed Patient experience, safety & effectiveness Patient experience To be confirmed To be confirmed Effectiveness To be confirmed To be confirmed Safety & effectiveness Optimising Resource Use in Specialised Eating Disorders Services Assuring the Appropriateness of Unplanned Admissions To be confirmed To be confirmed Patient experience & effectiveness 1 2 3 4 MH7 5 MH8 6 MH9 7 MH17 8 Particulars 2014/15 NHS Standard Contract – v11 Goal weighting (% of CQUIN scheme available) To be confirmed Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) Patient experience Patient experience & effectiveness 2014/15 NHS STANDARD CONTRACT PARTICULARS National CQUIN Templates: Friends and Family Test (from CQUIN Guidance section 5) FRIENDS AND FAMILY TEST – IMPLEMENTATION OF STAFF FFT - NHS TRUSTS ONLY Indicator number 1a Indicator name Friends and Family Test – Implementation of staff FFT Indicator weighting <commissioner to complete – minimum (% of CQUIN scheme available) 0.0375% of contract value> Description of indicator Implementation of staff FFT as per guidance, according to the national timetable Numerator Not applicable Denominator Not applicable Rationale for inclusion National CQUIN scheme Data source Local provider response to local commissioners Frequency of data collection Check on implementation at end of July 2014 Organisation responsible for data Provider collection Frequency of reporting to One off commissioner Baseline period/date Not applicable Baseline value Not applicable Final indicator period/date (on July 2014 which payment is based) Final indicator value (payment Provider to demonstrate to commissioner threshold) that staff FFT has been delivered across all staff groups as outlined in guidance Final indicator reporting date Response from providers to commissioners by 31 July 2014 Are there rules for any agreed inFunding payable once July 2014 indicator year milestones that result in achieved payment? Are there any rules for partial Not applicable achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS FRIENDS AND FAMILY TEST: EARLY IMPLEMENTATION Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to commissioner) Final indicator reporting date Are there rules for any agreed inyear milestones that result in payment? Are there any rules for partial achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 1b Friends and Family Test – early implementation <commissioner to complete – minimum 0.0188% of contract value for acute providers minimum of 0.05% for other providers> Early implementation Not applicable Not applicable National CQUIN scheme Local provider response to local commissioners Check on implementation at end of October 2014 Provider One off activity Not applicable Not applicable October 2014 Full delivery of FFT across all services delivered by the provider as outlined in guidance Provider to demonstrate to commissioner that milestone has been met Response from providers to commissioners by 31 October 2014 Not applicable For acute providers, there will be no payment for partial achievement. For other providers, partial implementation will result in receiving half of the funding available for the indicator (20% of the FFT CQUIN). There will be further guidance on the conditions for partial funding. 2014/15 NHS STANDARD CONTRACT PARTICULARS FRIENDS AND FAMILY TEST: PHASED EXPANSION Indicator number 1c Indicator name Friends and Family Test - Phased expansion Indicator weighting <commissioner to complete – minimum (% of CQUIN scheme available) 0.0375% of contract value> Description of indicator Phased expansion Numerator Not applicable Denominator Not applicable Rationale for inclusion National CQUIN scheme Data source Local provider response to local commissioners Frequency of data collection Check on implementation at end of January 2015 Organisation responsible for data Provider collection Frequency of reporting to One off commissioner Baseline period/date Not applicable Baseline value Not applicable Final indicator period/date (on January 2015 which payment is based) Final indicator value (payment Full delivery of the nationally set milestones threshold) Rules for calculation of payment Provider to demonstrate to commissioner due at final indicator period/date that milestones have been met (including evidence to be supplied to commissioner) Final indicator reporting date Response from providers to commissioners by 31 January 2015 Are there rules for any agreed inNot applicable year milestones that result in payment? Are there any rules for partial Not applicable achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS FRIENDS AND FAMILY TEST: INCREASED RESPONSE RATE FFT IN ACUTE PROVIDERS Indicator number 2 Indicator name Friends and Family Test – Increased or Maintained Response Rate Indicator weighting <commissioner to complete – minimum (% of CQUIN scheme available) 0.0188% of contract value> Description of indicator Increased or maintained response rate Numerator Not applicable Denominator Not applicable Rationale for inclusion National CQUIN scheme Data source Provider submission via UNIFY data collection system Frequency of data collection Monthly return Organisation responsible for data Provider collection Frequency of reporting to Monthly commissioner Baseline period/date See below Baseline value See below Final indicator period/date (on Q4 in 2014/15 which payment is based) Final indicator value (payment A response rate for Quarter 4 that is at least threshold) 20% for A&E services and at least 30% for inpatient services Final indicator reporting date Data available by end of April 2015 (for Q4) Are there rules for any agreed inYes – see below year milestones that result in payment? Are there any rules for partial No achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Improving physical healthcare to reduce premature mortality in people with severe mental illness (SMI) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to commissioner) Particulars 2014/15 NHS Standard Contract – v11 1 Cardio Metabolic Assessment for Patients with Schizophrenia 0.08125% To demonstrate, through the National Audit of Schizophrenia, full implementation of appropriate processes for assessing, documenting and acting on cardio metabolic risk factors in patients with schizophrenia The audit sample must cover all relevant services provided by the provider As set out in the National Audit of Schizophrenia As set out in the National Audit of Schizophrenia National CQUIN scheme National Audit of Schizophrenia One-off, expected to be during Quarter 3 of 2014/15 Provider One-off, through the National Audit of Schizophrenia, expected to be during Quarter 4 of 2014/15 Not applicable Not applicable October – December 2014 90.0% The provider’s results from the National Audit of Schizophrenia demonstrate that, for 90% of patients audited, the provider has undertaken an assessment of each of the following key cardio metabolic parameters (as per the 'Lester tool'), with the results recorded in the patient's notes/care plan/discharge documentation as appropriate, together with a record of associated interventions (eg smoking cessation programme, lifestyle advice, medication review, treatment according to NICE guidelines or onward referral to another clinician for 2014/15 NHS STANDARD CONTRACT PARTICULARS assessment, diagnosis, and treatment) The parameters are: Smoking status Lifestyle (including exercise, diet alcohol and drugs) Body Mass Index Blood pressure Glucose regulation (HbA1c or fasting glucose or random glucose as appropriate) Blood lipids Hepatitis C Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment? Are there any rules for partial achievement of the indicator at the final indicator period/date? 30 April 2015 No Rules for partial achievement at final indicator period/date Final indicator value for the partial achievement threshold 49.9% or less 50.0% to 69.9% 70.0% to 79.9% 80.0% to 89.9% 90.0% or above % of CQUIN scheme available for meeting final indicator value Particulars 2014/15 NHS Standard Contract – v11 Yes – see below No payment 25% payment 50% payment 75% payment 100% payment 2014/15 NHS STANDARD CONTRACT PARTICULARS PATIENTS ON THE CPA: COMMUNICATION WITH GENERAL PRACTITIONERS Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Particulars 2014/15 NHS Standard Contract – v11 2 Patients on the CPA: Communication with General Practitioners 0.04375% Completion of a programme of local audit of communication with patents’ GPs, focusing on patients on the CPA, demonstrating by Quarter 4 that, for 90% of patients audited, an up-to-date care plan has been shared with the GP, including ICD codes for all primary and secondary mental and physical health diagnoses, medications prescribed and monitoring requirements, physical health condition and ongoing monitoring and treatment needs The number of patients in the audit sample for whom the provider has provided to the GP an up-to-date copy of the patient’s care plan, which sets out appropriate details of all of the following: all primary and secondary mental and physical health diagnosis, including ICD codes; medications prescribed and monitoring requirements; and physical health condition and ongoing monitoring and treatment needs A sample of 100 patients who are subject to the CPA and who have been under the care of the provider for at least 100 days at the time of the audit National CQUIN scheme Local audit Two audits, one in Quarter 2, one in Quarter 4 Provider Reports required in respect of Quarter 2 and Quarter 4 Not applicable Not applicable January – March 2015 90.0% 2014/15 NHS STANDARD CONTRACT PARTICULARS Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to commissioner) Quarter 4 audit demonstrates that, for 90% of patients audited during the period, the provider has provided to the GP an up-todate copy of the patient’s care plan, which sets out appropriate details of all of the following: ntal and physical health diagnosis, including ICD codes; requirements; and monitoring and treatment needs Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment? Are there any rules for partial achievement of the indicator at the final indicator period/date? 30 April 2015 Yes – see below Yes – see below Milestones Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to commissioner) Date milestone to be reported Quarter 2 Audit methodology and sampling approach agreed, baseline audit completed and findings reported Final audit demonstrates that, for 90.0% of patients audited during the period, the provider has provided to the GP an up-to-date copy of the patient’s care plan, which sets out appropriate details of all of the following: 31 October 2014 Milestone weighting (% of CQUIN scheme available) 30% 30 April 2015 70 Quarter 4 mental and physical health diagnosis, including ICD codes; and monitoring requirements; and and ongoing monitoring and treatment needs Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Rules for partial achievement at final indicator period/date This provides for a sliding scale of payment in relation to the 70 per cent element of the indicator which is payable on the basis of the actual audit results for Quarter 4. Final indicator value for the partial achievement threshold 49.9% or less 50.0% to 69.9% 70.0% to 79.9% 80.0% to 89.9% 90.0% or above Particulars 2014/15 NHS Standard Contract – v11 % of CQUIN scheme available for meeting final indicator value No payment 25% payment 50% payment 75% payment 100% payment 2014/15 NHS STANDARD CONTRACT PARTICULARS Template for indicators for local CQUINs (from CQUIN Guidance Appendix C) To embed the routine use of specialised services quality dashboards that have been developed during 2013/14 Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Final indicator reporting date Are there rules for any agreed inyear milestones that result in payment? Are there any rules for partial achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 Indicator MH1 Specialised Services Quality Dashboards This indicator is aimed at ensuring that Providers embed and routinely use the required clinical dashboards developed during 2013/14 for specialised services. The Area Team is responsible for agreeing the relevant dashboards with the providers. Number of dashboards correctly completed Relevant number of dashboards for the provider As part of quality assurance for commissioners that specialised services are safe and effective for patients Providers Quarterly [Name of provider] Quarterly N/A N/A End of Q4 2014/15 Targets are set out as part of quarterly monitoring and payment requirements. End of quarter four period in 2015 (June) See quarterly monitoring requirements No 2014/15 NHS STANDARD CONTRACT PARTICULARS Milestones Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Date milestone to be reported Quarter 1 End Q1 – dates will be published Targets for end Q1: The Provider must: • Submit data for Q1 against all the required dashboards in line with the dashboards reporting arrangements • Confirm that data have been submitted within the specified deadline against all relevant dashboards • Provide a brief summary of how the dashboard products have been used within the Trust Where the Provider does not provide satisfactory evidence in the specified areas a penalty up to a maximum of the level specified in brackets will apply against the quarterly value of this indicator Particulars 2014/15 NHS Standard Contract – v11 Milestone weighting (% of CQUIN scheme available) Where all the Q1 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid. 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Date milestone to be reported Quarter 2 End Q2 – dates will be published Targets for end Q2: The Provider must: • Submit data for Q2 against all the required dashboards in line with the dashboards reporting arrangements • Confirm that data have been submitted within the specified deadline against all relevant dashboards • Provide a summary of how the dashboard products are being used within the Trust • Identify any key issues that have been identified Where the Provider does not provide satisfactory evidence in the specified areas a penalty up to a maximum of the level specified in brackets will apply against the quarterly value of this indicator Particulars 2014/15 NHS Standard Contract – v11 Milestone weighting (% of CQUIN scheme available) Where all the Q2 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid. 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Date milestone to be reported Quarter 3 End Q3 – dates will be published Targets for end Q3: The Provider must: • Submit data for Q3 against all the required dashboards in line with the dashboards reporting arrangements • Confirm that data have been submitted within the specified deadline against all relevant dashboards • Provide a summary of how the dashboard products are being used within the Trust • Identify any key issues that have been identified Where the Provider does not provide satisfactory evidence in the specified areas a penalty up to a maximum of the level specified in brackets will apply against the quarterly value of this indicator Particulars 2014/15 NHS Standard Contract – v11 Milestone weighting (% of CQUIN scheme available) Where all the Q3 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid. 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Date milestone to be reported Quarter 4 End Q4 – dates will be published Targets for end Q4: The Provider must: • Submit data for Q4 against all the required dashboards in line with the dashboards reporting arrangements • Confirm that data have been submitted within the specified deadline against all relevant dashboards • Provide a summary of how the dashboard products are being used within the Trust • Identify any key issues that have been identified Milestone weighting (% of CQUIN scheme available) Where all the Q4 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid. Where the Provider does not provide satisfactory evidence in the specified areas a penalty up to a maximum of the level specified in brackets will apply against the quarterly value of this indicator Rules for partial achievement at final indicator period/date Final indicator value for the partial achievement threshold Particulars 2014/15 NHS Standard Contract – v11 % of CQUIN scheme available for meeting final indicator value 2014/15 NHS STANDARD CONTRACT PARTICULARS COLLABORATIVE RISK ASSESSMENTS Indicator number MH5 Indicator name Collaborative Risk Assessments Education Indicator weighting (% of CQUIN scheme available) XX % Description of indicator The provision of an education training package for patients and qualified staff around collaborative risk assessment and management. Numerator Not applicable Denominator Not applicable Rationale for inclusion Currently very few users of forensic services are actively involved in their risk assessment and developing their risk management plan. (50 % of CQUIN scheme available) The Department of Health ‘Best Practice in Managing Risk Guidelines 2007’ advises that a collaborative approach involving service users should be used in the risk assessment process. My Shared Pathway (a previous Secure Service CQUIN) promotes collaborative approaches to a service user’s care and treatment provided by secure services. Furthermore, recovery approaches emphasise that risk management should be built on the recognition of the service user’s strengths and should emphasise recovery, and this is more likely to be achieved using a collaborative approach. Data source Provider Frequency of data collection Bi-annual Organisation responsible for data collection Provider Frequency of reporting to Bi-annual Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS commissioner Baseline period/date Not applicable Baseline value Not applicable Final indicator period/date (on which payment is based) Q2. Report by the provider detailing the education package the provider has developed for staff and service users about risk assessment and risk management. The training will encompass a wide range of risks (including positive risk taking), and will not be limited to just risk of violence. The training will be provided jointly to both staff and service users in order to promote discussion (It is recognised that not all staff would be able to attend joint sessions and so provision should be made for the training to be delivered to them with service user reflections from joint training reflected in this). The report will explicitly specify how the training package will support the eventual goal of risk assessment and management plans being developed in a collaborative manner between the service user and the clinical team (and specifically, training on how to approach and conduct a risk assessment in collaboration with a service user). Q4. Written report by the provider detailing the delivery of the educational program to staff and service users about risk assessment and risk management. 90 % of qualified clinical staff to have received training in collaborative risk assessment. All service users to have been offered relevant education and training or, if not clinically well enough, detail in their care plan as to when training will be offered. Final indicator value (payment threshold) Particulars 2014/15 NHS Standard Contract – v11 Q2. 40 % of this CQUIN value 2014/15 NHS STANDARD CONTRACT PARTICULARS Q4. 60 % of this CQUIN value Final indicator reporting date 30 April 2015 Are there rules for any agreed in-year milestones that result in payment? Q2 report must be submitted in order to be eligible for the Q4 payment. Are there any rules for partial achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS NEEDS FORMULATION AT TRANSITION Indicator number MH7 Indicator name Service user formulation of need at key points of transition Indicator weighting (% of CQUIN scheme available) XX % Description of indicator To provide the service user information detailing a formulation of both current and potential future needs and how the proposed service might best meet them. Numerator Not applicable Denominator Not applicable Rationale for inclusion Transitions are a critical point in the secure pathway, associated with significant risk as well as anxiety for the service user. It is important that providers clearly identify what a service user’s needs are at these points of transition and convey this to the service user. The formulation will be brief explanation as to what the service user should expect to receive from the service provider and why. Data source Provider Frequency of data collection Quarterly Organisation responsible for data collection Provider Frequency of reporting to commissioner Quarterly Baseline period/date Not applicable Baseline value Not applicable Final indicator period/date (on which payment is based) Q1. Particulars 2014/15 NHS Standard Contract – v11 (25 % of CQUIN scheme available) Provider will develop a system for sending a formulation to service users following acceptance into a service of what their current needs are and how these needs will be met. The three critical point of transition covered by this CQUIN are: 2014/15 NHS STANDARD CONTRACT PARTICULARS Initial admission into secure services Transfer to a new provider Transfer to a new level of security (whether up or down) Q2, Q3 and Q4 Provider will audit the provision of a formulation covering current need (audit tool to be developed) Final indicator value (payment threshold) Q1 25 % of this CQUIN Q2 25 % of this CQUIN Q3 25 % of this CQUIN Q4 25 % of this CQUIN Final indicator reporting date 30 April 2015 Are there rules for any agreed in-year milestones that result in payment? Q1 Report received detailing how the provider will provide a formulation, detailing the process and expected content of the formulation. Provider will develop a written protocol that is informed by the information in the report. The timescale for provision of the needs formulation will be either prior to or within 1 week of admission/transfer where necessary. Q2 .The provider will pilot the protocol on 50% of service users who they agree to admit or who are admitted during the quarter and refine the procedure/protocol as necessary. Provider to report on pilot of protocol Q3 75 % of service users agreed for admission or admitted to provider service receive formulation of need prior to or within 1 Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS week of admission / transfer Q4 100 % of service users agreed for admission or admitted to provider service receive formulation of need prior to or within 1 week of admission / transfer Are there any rules for partial achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 At Q4, NHS England can use their discretion as to whether failure to achieve 100% was reasonable and/or within the control of the provider. 2014/15 NHS STANDARD CONTRACT PARTICULARS OUTCOME MEASURES –ADULT EATING DISORDERS Indicator number MH8 Indicator name Adult Eating Disorders- Outcome measures Indicator weighting (% of CQUIN scheme available) Description of indicator To systematically collect outcome measures for individuals receiving inpatient care at admission and discharge Numerator Denominator Rationale for inclusion The systematic collation of outcomes data should aid the qualitative understanding of the effectiveness of interventions within inpatient care Data source Provider Frequency of data collection Quarterly Organisation responsible for data Provider collection Frequency of reporting to Quarterly commissioner Baseline period/date N/A Baseline value N/A Final indicator period/date (on which payment is based) Final indicator value (payment N/A threshold) Final indicator reporting date Are there rules for any agreed inN/A year milestones that result in payment? Are there any rules for partial N/A achievement of the indicator at the final indicator period/date? Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Milestones Date/period Rules for achievement of milestones milestone (including evidence to be supplied relates to to commissioner) Quarter 1 To provide a report of all discharges during the quarter, detailing the following on admission and discharge: EDEQ BMI Length of stay Also containing a qualitative narrative of any significant factors impacting on patient’s outcomes. Quarter 2 Quarter 3 Quarter 4 As Q1 As Q2 To provide a composite report of above information for the 12 months along with recommendations for further action Particulars 2014/15 NHS Standard Contract – v11 Date milestone to be reported Milestone weighting (% of CQUIN scheme available) 2014/15 NHS STANDARD CONTRACT PARTICULARS OPTIMISING RESOURCE USE IN THE SPECIALISED ADULT EATING DISORDERS SERVICES Indicator number MH9 Indicator name Optimising resource use in specialised adult eating disorders services Indicator weighting (% of CQUIN scheme available) Description of indicator To identify those patients who have been on an eating disorder ward for over 10 months, to describe these patients and establish what is preventing progress in treatment and discharge from hospital. Numerator Not applicable Denominator Not applicable Rationale for inclusion National CQUIN to enable a better understanding of this group of patients and the outcomes achieved in an extended hospital stay to inform future service model development Data source Local audit and description Frequency of data collection Each quarter to describe inpatients and day patients (count in and day patient episode together) who meet the criteria and follow up descriptions of patients, what is keeping the patient in hospital, plan for next steps and progress including realistic milestones and time frame. Audit of outcome measures for these patients to include HoNOS, BMI and EDE-Q. at either discharge or in Q4 Provider Organisation responsible for data collection Frequency of reporting to commissioner Baseline period/date Each Quarter to provide new patient descriptions and updates of progress. To provide outcome data in the quarter discharged or in last quarter if not discharged. N/A Baseline value N/A Final indicator period/date (on which payment is based) Q4 Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Final indicator value (payment threshold) Final indicator reporting date 30 April 2015 Are there rules for any agreed inyear milestones that result in payment? No Are there any rules for partial achievement of the indicator at the final indicator period/date? No Milestones Date/period Rules for achievement of milestones milestone (including evidence to be supplied relates to to commissioner) Particulars 2014/15 NHS Standard Contract – v11 Date milestone to be reported Milestone weighting (% of CQUIN scheme available) 2014/15 NHS STANDARD CONTRACT PARTICULARS Quarter 1 Provision of the following information for patients who have been in hospital for 10 months or longer and/ or admitted 5 times or greater. 1. Admission date and length of stay as at end of Q1 end June 2014. 2. Detained or voluntary patient/ CTO 3. Age, DOB of patient 4. List all co- morbid psychiatric diagnoses with ICD 10 codes with best estimate of when diagnoses made. (please indicate if purging) 5. Report on physical status of patient. BMI, biochemical status, ECG abnormalities and physical risk estimate. 6. Report on non physical risk e.g. self harm, suicidal risk, violence 7. Report on physical diagnoses, e.g.fractures, hx of fracture 8. Report on method of feeding, oral food/supplements/ng feeding/PEG and how long 9. Report of if use of 1:1 or 2:1 time and how long been used. 10. Report on unmet needs, e.g. housing, lack of community team unwilling to have discharged. esp those that impact on ability to discharge. 11. Summary of what is impacting on moving the treatment forward making progress with moving to independence and discharge 12. Admission BMI, HONOS, EDEQ and , BMI, HONOS and EDEQ scores at time of reporting Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Quarter 2 As above but next steps for those reported on in Q1 and reporting on new cases that meet the criteria. Report on discharge if occurs and how it was possible to do so, i.e. what changed. Provide discharge BMI, EDE-Q and Honos. Quarter 3 Same as above Quarter 4 Same as above Rules for partial achievement at final indicator period/date Final indicator value for the partial achievement threshold Particulars 2014/15 NHS Standard Contract – v11 % of CQUIN scheme available for meeting final indicator value 2014/15 NHS STANDARD CONTRACT PARTICULARS Assuring the appropriateness of unplanned admissions (2014/15) Indicator number MH17 Indicator name Assuring the appropriateness of unplanned admissions (2014/15) Indicator weighting (% of CQUIN scheme available) Description of indicator This scheme proposes a multi-agency review of all unplanned admissions to general adolescent Tier 4 CAMHS within 5 working days of admission in order to: Confirm that local gatekeeping/access assessment procedures have been followed. Confirm the clinical appropriateness of admission Ensure an appropriate care plan is agreed and in place if admission is deemed appropriate. Ensure ownership of the patient pathway by the local Tier 3 CAMHS service. Expedite discharge if admission is determined to be unwarranted clinically. Expedite referral to Social Care where this is required. Ensure the participation of the child/young person and their parents/carers in the decision making process. Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Multi-agency clinical review team to involve: Admitting Tier 4 service Patient’s local Tier 4 service Patient’s local Tier 3 service Originating Area Team Case Manager The review may be carried out by tele / videoconference where travel to the Tier 4 CAMHS is difficult. The review will involve the child/young person and their parents / carers. Where other agencies are involved such as Social Care they should also be involved. Numerator Denominator Rationale for inclusion Particulars 2014/15 NHS Standard Contract – v11 See monitoring requirements A guiding principle for inpatient referral should be that the child or young person’s needs cannot be managed safely or effectively within the community or in an intensive community service. This is because only those children and young people with the greatest needs should be referred to the most intensive level of service provision and because hospital admission may make their overall difficulties worse rather than better 2014/15 NHS STANDARD CONTRACT PARTICULARS given the potential for disruption to personal, educational, social and family functioning. National guidance on inpatient CAMHS advocates that admission should operate within a pathway of care, involving the local community team. As more Tier 4 adolescent units are offering emergency access, unplanned admissions are steadily increasing and these referrals may bypass local processes especially when they occur out of hours. The expected outcomes of this scheme are: To promote a reduction in clinically inappropriate unplanned admissions to general adolescent services. Strengthening adherence to local gatekeeping/access assessment procedures. Improved demand management in and out of hours. To promote a reduction in out of area admissions. For the purposes of this CQUIN scheme, the following definitions are offered: Planned Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS referral/admission – where the aims and objectives for admission are identified collaboratively with the child or young person, their parents or carers and the referrer or wider community team. These objectives should be SMART (specific, measurable, achievable, realistic, time bound). Unplanned/Emergency referral/admission – where the need for immediate containment and management of risks associated with acute mental disorder is required. In these circumstances it may not be safe or practical to agree admission aims beyond those required to ensure safety and rapid assessment and/or treatment. Inappropriate admission: Admission which is unnecessary or avoidable because the young person’s presenting difficulties could be adequately addressed by an alternative service, e.g. Tier 3 CAMHS or social care. Admission which is potentially harmful as it runs the risk of exacerbating the young person’s difficulties. Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Data source Provider generated reports transferred to commissioners by secure email using NHS Net Frequency of data collection Quarterly Organisation responsible for data collection Provider Frequency of reporting to commissioner Quarterly Baseline period/date Q1 2014/15 Baseline value Number of reviews held in Q1 2014/15 Final indicator period/date (on which payment is based) Q4 2014/2015 Final indicator value (payment threshold) Commissioner to complete [min 60% improvement in number of reviews held within 5 working days of unplanned admission recommended] Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to commissioner) Providers will need to submit data Quarterly using template issued by NHS England. Every quarter providers are required to embed data with supporting narrative to quarterly reports. In quarterly monitoring for Q4 (end March 2015) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment? Yes Are there any rules for partial achievement of the indicator at the final indicator period/date? Providers are offered 5 working days to clarify submission data in the event of queries from commissioner. Milestones Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Quarter 1 The provider must submit the following: Quarterly reporting template (using recording proforma attached) submitted to provide baseline position: Date of each unplanned admissions in the quarter Date of the multi-agency review meeting held for each unplanned admission List of participants including the organisation they represent and a list of invites issued including the organisation they represent. Evidence of pathway plan agreed at each review meeting and evidence of action taken. Quarter 2 Quarterly reporting template (using recording proforma attached) submitted to illustrate: Date of each unplanned admission in the quarter Date of the multi-agency review meeting held for each unplanned admission indicating xx% improvement [improvement target to be agreed locally] in number of reviews held within 5 working days of unplanned admission against baseline position. Particulars 2014/15 NHS Standard Contract – v11 Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Where all the Q1 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid (per quarter). Where all the Q2 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid (per quarter). 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Quarter 3 List of participants including the organisation they represent and a list of invites issued including the organisation they represent. Evidence of pathway plan agreed at each review meeting and evidence of action taken. The provider must submit the following: Quarterly reporting template (using recording proforma attached) submitted to illustrate: Date of each unplanned admission in the quarter Date of the multi-agency review meeting held for each unplanned admission indicating xx% improvement [improvement target to be agreed locally] in number of reviews held within 5 working days of unplanned admission against baseline position. List of participants including the organisation they represent and a list of invites issued including the organisation they represent. Evidence of pathway plan agreed at each review meeting and evidence of action taken Quarter 4 The provider must: Particulars 2014/15 NHS Standard Contract – v11 Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Where all the Q3 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid (per quarter). Where all 2014/15 NHS STANDARD CONTRACT PARTICULARS Date/period Rules for achievement of milestone milestones (including evidence to relates to be supplied to commissioner) Date of each unplanned admission in the quarter Date of the multi-agency review meeting held for each unplanned admission indicating xx% improvement [improvement target to be agreed locally] in number of reviews held within 5 working days of unplanned admission against baseline position. List of participants including the organisation they represent and a list of invites issued including the organisation they represent. Evidence of pathway plan agreed at each review meeting and evidence of action taken. Annual report of issues arising from agreed pathway plans and evidence of action taken. Particulars 2014/15 NHS Standard Contract – v11 Date milestone to be reported Milestone weighting (% of CQUIN scheme available) the Q4 requirements are met, 25% of annual CQUIN monies associated with this indicator will be paid (per quarter). 2014/15 NHS STANDARD CONTRACT PARTICULARS Rules for partial achievement at final indicator period/date Final indicator value for the part achievement threshold Q1 Q2 Q3 % of CQUIN scheme available for meeting final indicator value Q4 Template populated, including narrative >74% 100% >84% >94% achievement Payable achievement achievement of of of improvement improvement improvement target target target Template populated, no narrative 65 -74% 75 -84% 85 -94% 80% achievement achievement achievement Payable of of of improvement improvement improvement target target target Template partially populated <65% <75% <85% No achievement achievement achievement Payment of of of improvement improvement improvement target target target Particulars 2014/15 NHS Standard Contract – v11 2014/15 NHS STANDARD CONTRACT PARTICULARS CQUIN Proforma for Recording 5 Working Day Review of Unplanned Admissions To be completed by admitting service for each unplanned admission as defined in CQUIN scheme Pseudonymised Patient Number Date of Admission dd/mm/yy Date of Review dd/mm/yy Did Review take place within 5 working days Y/N of admission? If Review did not take place within 5 working days of admission, explain reasons why? Was there representation at the review from (a) Local Tier 3 Services? (b) Admitting Tier 4 Service? (c) Local Tier 4 Service? (d) Originating Area Team Case Manager (e) Admitted Young Person (f) Parents/Carers of Admitted Young Person (g) Other local agencies, e.g. social care Is there agreement that the admission was necessary and unavoidable? Audit Report Statistic % Reviews held within 5 working days % Reviews with representation from all parties Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N If the admission was considered by any party as avoidable which statement below applies (a) In-patient assessment demonstrated that on admission, there was a lower level of risk than indicated at referral Y/N (b) There was insufficient involvement of Tier 3 /Crisis Resolution Home Treatment Services prior to referral Y/N (c) There was an inadequate response from social care Y/N % Reviews where this issue was raised as an issue % Reviews where the cause for an avoidable admission was specified (d) Other : Please Specify Is there agreement that the admission has been more harmful to the child/young person’s development than if the admission had not taken place? Was the potential harmfulness of the Particulars admission considered in the risk assessment 2014/15 NHS Standard Contract – v11 Y/N Y/N % Reviews where potential harmfulness raised as issue % Reviews where relative risk raised 2014/15 NHS STANDARD CONTRACT PARTICULARS prior to referral? Has the harmful admission been reported to the referring CCG as adverse event under the local Serious Incident process? Particulars 2014/15 NHS Standard Contract – v11 Y/N as an issue % Harmful admissions reported to referring CCG as an adverse event
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