NICE, the health and social care guidance body, has today (Thursday 1 August) published 15 proposed new indicators to support better quality healthcare being commissioned by Clinical Commissioning Groups - the local NHS bodies, led by clinicians, which oversee the delivery of NHS services across England. The new indicators could be included in a wider set of benchmarks, known as the Clinical Commissioning Groups Outcomes Indicator Set.

Indicators underpin health improvement such as enhancing quality of life for people with long-term conditions and preventing people from dying prematurely.

This menu of indicators will now be considered by NHS England for inclusion in the indicator set for 2014/15. Indicators were introduced in April 2013 to help Clinical Commissioning Groups (CCGs) improve quality of care and results for patients.

Areas covered by the menu of indicators include aspects of care relating to hip fracture; measures of the stage at which different cancers are diagnosed and reducing the numbers of premature deaths among people with serious mental illness.

Some proposed indicators are:

• Cancers diagnosed via emergency routes
  • This indicator measures the proportion of people with cancer (excluding non-melanoma skin cancer) who first present to secondary care as an emergency. About a quarter of people with cancer are diagnosed via emergency routes, and survival for these people is lower than for those diagnosed via other routes. This indicator can prompt investigation into how to encourage people to go to a relevant clinic earlier and therefore improving rates of survival.
• Smoking rates in people with serious mental illness
  • Smoking is the biggest cause of preventable ill health and premature death in the UK. It has been reported that deaths from smoking-related diseases are twice as high among people with schizophrenia. This indicator measures the percentage of people with serious mental illness who smoke. It will support local understanding of smoking rates in people with serious mental illness, and should prompt action which should lead to improved health.

The indicators are identified and developed from NICE quality standards and from other existing indicator collections, for example, national audits. Final indicators will be decided by NHS England, which may include additional indicators.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “We're pleased to be publishing this new menu of indicators for clinical commissioning groups recommended by the independent advisory committee. These potential indicators will encourage high quality commissioning of NHS services in England and lead to better healthcare for patients. Each indicator has been through public consultation and feasibility testing (conducted by the Health and Social Care Information Centre), so commissioners can be reassured that they will work in practice.

“By setting out the aspects of care that are essential in enabling the best health outcomes, the quality of care being commissioned for local people can be measured. For example, detecting cancer at an early stage can improve prognosis, so the indicator on measuring the timeliness of cancer diagnosis can help reveal whether there are a lot of late stage diagnoses which could be due to delays in people receiving a diagnosis. This general approach will enable the groups responsible for commissioning NHS care to make changes based on local needs, and will ultimately improve the standards of health care.”

Professor Danny Keenan, the chair of the Advisory Committee for the Clinical Commissioning Groups Outcome Indicator Set, said: “The independent CCG OIS Advisory Committee is made up of GPs, hospital doctors, patients and commissioners. They bring a broad range of expertise to indicator development. This ensures that the menu of indicators is workable, and can help improve the quality of commissioning and patient care. We're delighted to recommend this robust set of indicators for potential inclusion in the 2014/15 indicator set. We hope they will help the new CCGs to commission NHS services that will improve the quality of people's lives.”

The Committee's recommendations for the 2014/2015 menu of indicators are available. The selection of the final indicators will be decided by NHS England in autumn 2013.

Ends

Notes to Editors

About the Clinical Commissioning Groups Outcome Indicator Set (CCG OIS)

1. Clinical Commissioning Groups (CCGs) took over responsibility for commissioning the majority of NHS services in England from April 2013. This includes the services in secondary care and community care. All GP practices in England are required to join one of the CCGs.
2. NHS England, supported by NICE and working with professional and patient groups, has developed a CCG OIS that measures the health outcomes and quality of care (including patient reported outcome measures and patient experience) commissioned by CCGs.
3. NICE was originally commissioned by the Department of Health to develop indicators for the CCG OIS. The CCG OIS is now the responsibility of NHS England. NICE opened a public consultation on this set of indicators in February 2013, and these indicators have since also undergone feasibility testing (as conducted by the Health and Social Care Information Centre which involved analysis of data sets to ensure that indicators are measurable and meaningful) before further consideration by the independent CCGOIS advisory Committee in May 2013.
4. The CCG OIS may also include indicators from the NHS outcomes framework that can be measured at CCG level. NICE is not responsible for the development of these indicators.
5. The range of clinical topics covered by the indicators will reflect the available quality standards topics. As more quality standards are developed, the breadth of clinical topics covered by CCG OIS indicators is expected to increase accordingly. The core library of quality standards is available on the NICE website.
6. The CCGOIS indicators will focus on quality and reducing health inequalities. This will form part of a wider system of accountability for CCGs which will cover CCGs' financial performance, their contribution to joint health and wellbeing strategies, and fulfilment of other statutory duties such as patient and public involvement. The set of indicators which NICE has developed will not, however, cover these wider areas: its focus is on the quality of the health services commissioned, not on how they are commissioned. NICE will not be responsible for setting the Quality Premium Payments. For media enquiries about how the CCG OIS works in practice, please contact the NHS England press office on 0113 825 1111.

About NICE

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