1. C Commissioner Perspective How Quality Neonatal Clinical Indicators may relate to CQINs & QIPPs Ruth Moore Network Manager/Lead Nurse SSBC Newborn Network

2. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence, by linking a proportion of healthcare providers' income to the achievement of local quality improvement goals aims to support a culture shift by embedding quality improvement and innovation as part of the commissioner – provider discussion Since 2009/10 (1st year) many CQUIN schemes have been developed and agreed nationally

3. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs CQUINs Continued… CQUINs have been developed separately for specialised services covering the 3 domains of quality, safety and clinical effectiveness  this has brought advantages including close collaboration with clinicians, networks and a regional approach There are a number of CQUIN schemes which have been developed and used for neonatal services  consultation with parents, retinopathy screening, breastfeeding, care pathway exception reporting For 2012/13 there is a move to a national consistent pick list for CQUIN schemes which is currently being developed with a CQUIN guidance document for all providers.  There will be a limited list of local schemes for local issues to be addressed. Neonatal services are on the national pick list. The final CQUIN schemes on the pick list has yet to be finalised  Payment in the past has been 1.5% of the total contract value, this may again apply in 2012/13 the Operating Framework due to be released in late 2011 will confirm this.

4. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Commissioning of neonatal services WM Specialised commissioning team (E & W) Midlands and East of England SCG Cluster National commissioning board The NHS Commissioning Board will seek to align various tools and levers to drive improved outcomes based on;  NICE quality standards.  NHS Outcome Framework (a key document with 5 domains) and  Quality dashboards

5. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Quality, Innovation, Productivity and Prevention (QIPP) QIPP is a large scale transformational programme for the NHS, involving all NHS staff, clinicians, patients and the voluntary sector to improve the quality of care the NHS delivers whilst making up to £20billion of efficiency savings by 2014-15, which will be reinvested in frontline care QIPP is engaging large numbers of NHS staff to lead and support change At a regional and local level SHAs have been developing integrated QIPP plans that address the quality and productivity challenge, and these are supported by the national QIPP work streams which are producing tools and programmes to help local change leaders in successful implementation

6. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs National Commissioning Board National Neonatal Service Specifications National Neonatal Quality Dashboard National Neonatal CQUIN schemes pick list National Neonatal QIPP schemes

7. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Development of Quality Dashboards Another innovation in the 2012/13 contracting round for specialised services Will require providers of a number of services to report a range of clinical data to commissioners While most of this data is readily available and collectable it will be up to the Trust to submit this according to detailed data requirements & set timescales The dashboards have been developed in collaboration with clinical leads & networks across the country, the timescales have been tight in preparedness for the contract negotiations The dashboards focus on patient outcomes for specific specialised services which will be part of a service specification which will also include performance measures Quality measures put into a dashboard format have been developed including neonatal services, cardiac, renal etc In the past quality has been monitored through the contracts in a quality schedule and have not always been specific to specialised services, this will enable specialised service line reporting

8. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Pilot of National Neonatal Dashboard Indicators – LNU/SCUs

9. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Pilot of National Neonatal Dashboard Indicators – NICUs

10. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs Pilot of National Neonatal Dashboard Indicators – Networks

11. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs National Neonatal CQUIN Pick list some ideas Continue Care pathway exception reporting 2 year follow up assessments Nurse staffing levels daily census relating to activity and complexity Transfers – speed of arrival at referring centre ROP screening term admission avoidance Non clinical transfers Inutero Transfers for non clinical reasons

12. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs National Neonatal QIPPs – Priority Areas Transitional Care Discharge Planning Infection Control Surgical Services Transition Integration with other services e.g. FaB (families & babies) Transport (Specification & Tariff) Parent Empowerment Procurement

13. How Quality Neonatal Clinical Indicators may relate to CQUINs & QIPPs