NHS Operating Framework 2012/2013 (England)
- Created on 25 November 2011
- Written by IJH
The Department of Health has published the NHS Operating Framework for 2012/2013 for England. The Operating Framework sets out the planning, performance and financial requirements for NHS organisations in 2012/13. One of the key themes is putting patients at the centre of decision making and improving dignity and service to patients. The care of older people and dementia services are given priority within the framework and the move towards an outcomes focused approach provides incentives to improve services for older people.
In his foreword to the document, Sir David Nicholson notes the urgent need to ensure that elderly and vulnerable patients receive dignified and compassionate care in every part of the NHS.
The framework states that organisations need to work together on the following areas:
- commissioners should ensure that providers are compliant with relevant NICE quality standards and ensure information is published in providers’ quality accounts;
- commissioners should work with GP practices to secure ongoing improvements in the quality of general practice and community services so that patients only go into hospital if that will secure the best clinical outcome;
- ensuring participation in and publication of national clinical audits that relate to services for older people;
- initiatives to reduce inappropriate antipsychotic prescribing for people with dementia to improve quality of life with a view to achieving overall a two-thirds reduction in the use of antipsychotic medicines;
- improving diagnosis rates, particularly in the areas with the lowest current performance;
- the continued drive to eliminate mixed-sex accommodation;
- the use of inappropriate emergency admission rates as a performance measure for national reporting; and
- non-payment for emergency readmissions within 30 days of discharge following an elective admission.
In addition to national leadership and incentives to support high-quality personal interactions between clinicians and patients, PCT clusters should ensure that all providers have a systematic approach to improving dignity in care for patients, to giving staff appropriate training and to incorporating learning from the experience of patients and carers into their work.
National Dementia Strategy
PCTs must continue to work with their local authorities and to publish dementia plans which set out locally the progress they are making on the National Dementia Strategy.
Developments of the payment system in 2012/13 are intended to increase the links with the quality of care, to drive integration of services and to incentivise delivery of the QIPP challenge. Increasing the scope of a more transparent rules-based funding system will be a priority in 2012/13. To this end, Payment by Results (PbR) will expand and develop to incentivise best clinical practice and better patient outcomes.
In 2012/13 best practice tariffs will be expanded to increase the payment differential between standard and best practice care for fragility hip fracture care and stroke.
CQUIN is a quality increment that applies to a level of service over and above the standard contract. In 2012/13, CQUIN will be developed so that, for all standard contracts, the amount that providers can earn will be increased to 2.5 per cent on top of actual outturn value. The two national goals on VTE risk assessment and on responsiveness to personal needs of patients will continue to be in place. There will also be a national goal to improve the diagnosis of dementia in hospitals and a national goal to incentivise use of the NHS Safety Thermometer (an improvement tool that allows NHS organisations to measure harm in four key areas (pressure ulcers, urine infection in patients with catheters, falls and VTE).
Joint working with local authorities
PCT clusters will need to work together with local authorities to agree jointly on priorities, plans and outcomes for investment of the monies allocated for reablement in 2012/13. This could include:
- current services such as telecare, community directed prevention (including falls prevention), community equipment and adaptations, and crisis response services;
- new services such as:
– funding the social care aspects of the National Dementia Strategy; and
– actively impacting on Delayed Transfers of Care, using local opportunities to develop the provision of post-discharge care and support services which are the responsibility of social services.