Several different quality incentive schemes operate in the National Health Service.
The Quality and Outcomes Framework is a voluntary pay for performance scheme within the general practitioner contract. It focuses upon improving the care of patients with one or more of 25 long term conditions. In 2018, NHS England undertook and published a Review of the Quality and Outcomes Framework which drew upon published evidence to evaluate its effectiveness and identify opportunities for reform. The recommendations made in the report are the subject of ongoing discussions with the General Practitioners Committee of the British Medical Association.
The Commissioning for Quality and Innovation (CQUIN) and Quality Premium schemes are intended to drive improvement by providers, and are administered by clinical commissioning groups and NHS England. The indicators in both are routinely reviewed as part of the NHS Planning Round to ensure that the schemes reflect the latest clinical priorities.
CQUIN has demonstrably helped secure improvements in certain areas: e.g. sepsis and venous thromboembolism management, hepatitis C treatment and staff flu vaccinations. However, we are also aware that some indicators have been less impactful, for example where we have pursued complex service changes or goals without a standard implementation method. The schemes are being reviewed with a view to changes in 2019/20.