NICE publishes first menu of COF indicators

NICE has today (Wednesday 1 August) published the first menu of 44 new proposed indicators recommended by the Commissioning Outcomes Framework (COF) Advisory Committee.

Covering domains including preventing people from dying prematurely, and enhancing quality of life for people with long term conditions, this menu of indicators will now be considered by the NHS Commissioning Board for potential inclusion in the 2013/14 COF. From April 2013, the COF will hold Clinical Commissioning Groups to account for improvement in quality of healthcare and patient outcomes through better commissioning.

Areas covered by the menu of indicators include aspects of care given immediately after a stroke and also following hospital discharge after treatment for stroke; chronic obstructive pulmonary disease; maternal care; and access to mental health services.

Examples of some specific proposed indicators are:

  • Emergency re-admissions within 30 days of discharge from hospital

(this indicator measures recovery from illnesses and injuries needing hospitalisation. Some readmissions may result from potentially avoidable adverse events, and so are used as a proxy for outcomes of care)

  • People who have had an acute stroke who receive thrombolysis

(this measures a key component of high-quality care as defined in the NICE stroke quality standard, which sets out that patients with suspected stroke should be admitted directly to a specialist acute stroke unit and assessed for thrombolysis, receiving it if clinically indicated).

The indicators are identified and developed from three sources: the NHS Outcomes Framework, NICE quality standards, and from other existing indicator collections, for example, national audits. Further COF indicators will be developed from NICE quality standards, meaning additional topics covered will reflect those within the library of quality standards. Further information about the core library is available on the NICE website. Planning is underway to schedule these topics for quality standard and indicator development.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “We're delighted to be publishing the first menu of COF indicators recommended by the independent advisory committee. These potential indicators will support high quality commissioning of NHS services in England, to deliver the best health outcomes 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 facilitating the best health outcomes, such as the need for people who have had an acute stroke to receive thrombolysis, the quality of care being commissioned for local populations can be measured. This will enable the groups responsible for commissioning NHS care to be held to account, and will ultimately drive up the standards of health care delivered.”

Professor Danny Keenan, COF Advisory Committee Chair, said: “The broad range of clinical expertise within the independent committee, including GPs, hospital doctors, patients and commissioners, ensures that the menu of COF indicators recommended are workable, and can help improve the quality of commissioning to benefit patient care. We're pleased to recommend this robust set of indicators for potential inclusion in the first COF, and hope that they will help the new commissioning groups to secure NHS services for their populations that will lead to improved health outcomes.”

The Committee's recommendations for the 2013/2014 menu of indicators are available from today.

The selection of the final indicators for inclusion within the 2013/14 COF will be decided by NHS Commissioning Board in autumn 2012.


Notes to editors

About COF

1. Clinical Commissioning Groups (CCGs) will take over responsibility for commissioning the majority of NHS services in England from April 2013. This will include the services in secondary care and community care. All GP practices in England will be required to join one of the CCGs.

2. The NHS Commissioning Board, supported by NICE and working with professional and patient groups, will develop a Commissioning Outcomes Framework (COF) that measures the health outcomes and quality of care (including patient reported outcome measures and patient experience) commissioned by CCGs.

3. NICE was commissioned by the Department of Health to begin the development of indicators for the COF. The Institute opened a public consultation on this first set of indicators in February 2012, 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 COF advisory Committee in May 2012

4. The range of clinical topics covered by the indicators will reflect the available quality standards topics. As there aren't currently quality standards on safety, indicators have not yet been developed for this domain. As more quality standards are developed, the breadth of clinical topics covered by COF indicators is expected to increase accordingly. The core library of quality standards is on our website.

5. The COF 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 proposed Commissioning Outcomes Framework will work in practice, or the NHS Commissioning Board, please contact the NHS Commissioning Board press office on 01138 25 1111. For media enquiries on the quality reward, please contact the Department of Health press office on 0207 210 5221.

About NICE

6. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

7. NICE produces guidance in three areas of health:

public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector

health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS

clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

8. NICE produces standards for patient care:

quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services

Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

Commissioning Outcomes Framework - NICE develops the potential indicators for the COF, the scheme starting in 2013, which will help measure the health outcomes and quality of care commissioned by Clinical Commissioning Groups.

9. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates high quality guidance and evidence-based information to help professionals deliver the best patient care through NHS Evidence.

This page was last updated: 31 July 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.