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