Supporting Clinical Commissioning Groups (CCGs) to deliver high-quality services

In November 2013, NHS England accepted 14 of NICE's proposed indicators for inclusion in the 2014/15 CCG OIS.

The Clinical Commissioning Group Outcomes Indicator Set (CCG OIS) aims to support and enable CCGs and health and wellbeing partners to plan for health improvement by providing information for measuring and benchmarking outcomes of services commissioned by CCGs.

It is also intended to provide clear, comparative information for patients and the public about the quality of health services commissioned by CCGs and the associated health outcomes.

The CCG OIS contains indicators from the NHS Outcomes Framework that can be broken down at CCG level and additional indicators that can help to deliver improvements in quality.

NICE's role is to provide support to NHS England by managing the process of developing these additional indicators for the CCG OIS. All indicators from the NICE CCG OIS indicator programme are evidence based and draw on our quality standards, our guidance or NICE accredited guidance.

In August 2013, we proposed 15 indicators for inclusion in the 2014/15 CCG OIS, including a number of indicators focused on improving cancer care.

Diagnosing cancer at an early stage is important as it can lead to simpler and more effective treatment, and better outcomes. To improve early diagnosis rates we put forward an indicator to measure new cases of cancer diagnosed at stage 1 and 2 as a proportion of all new cases of cancer diagnosed, where the cancer is of a type that can be staged.

Other clinical indicators included heart failure, stroke care, hip fracture and alcohol admissions and readmissions.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "These 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."

Professor Danny Keenan, Chair of the Advisory Committee for the Clinical Commissioning Groups Outcome Indicator Set, added: "We hope the indicators will help the new CCGs to commission NHS services that will improve the quality of people's lives."

In November 2013, NHS England accepted 14 of NICE’s proposed indicators for inclusion in the 2014/15 CCG OIS.

Improving the quality of care provided by family doctors 

Introduced in 2004, the Quality and Outcomes Framework (QOF) is an incentive scheme for GP practices in the UK, rewarding them for how well they care for patients.

NICE has been involved in developing clinical indicators for the QOF since 2009, following calls for a more independent and transparent process for reviewing and developing indicators.

In August 2013, NHS England formally asked NICE to undertake a piece of work to inform a review of the indicators within the clinical and public health domains of the QOF. This was a one off piece of work and outside of NICE’s normal role in the QOF. The aim of this work was to provide independent advice to NHS England about which indicators would be the most important to retain, in the event that the number of indicators within the QOF were reduced. The QOF Advisory Committee met in September 2013 to consider the request made by NHS England and to provide independent advice. The agenda, minutes and output from this meeting are all available.

In January 2014, NICE carried out a national consultation on potential new indicators for the 2015/16 QOF. The consultation included six proposed indicators relating to hypertension, as well as a potential indicator to improve the general care for people who have a diagnosis of diabetes.

The new list of 10 indicators in total was developed following recommendations from the QOF committee meetings, and indicators have been piloted in representative practices across the UK to test their feasibility and acceptability.

The QOF advisory committee will consider results of the piloting and consultation feedback in June 2014 before recommending which of these potential indicators should be included in the NICE menu. NHS England and the devolved administrations of Northern Ireland, Scotland and Wales use the NICE QOF menu during their negotiations. A process of negotiation between the four UK health departments, and general practitioners representatives ultimately decides which indicators will be included within the 2015/16 QOF.

The final QOF indicators will be published by NHS Employers.