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Measuring success

Measuring success

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In December 2012, NHS England released the first set of indicators - now referred to as the CCG Outcomes Indicator Set - on its website.  It was published as a package with technical guidance, alongside the planning guidance for CCGs Everyone Counts: Planning for patients 2013/14.  

The Health and Social Care Act (2012) places a duty on NHS England and CCGs to improve quality and outcomes. The consultation document Liberating the NHS: Commissioning for Patients proposed that NHS England, supported by the National Institute for Health and Care Excellence (NICE), would develop a ‘commissioning outcomes framework’ to provide information for the public on the quality of services they commission and the health outcomes achieved through commissioning. The title was changed in 2012 to CCG outcomes indicator set to avoid confusion with the NHS outcomes framework and make it clear that the indicators relate to outcomes from commissioned services.

During 2011 and 2012, the Department of Health and NHS England, then known as the NHS Commissioning Board, worked with NICE and the Health and Social Care Information Centre (HSCIC) to develop proposals for a process to develop robust, comparative outcome measures at clinical commissioning group (CCG) level.  

The NICE and HSCIC processes to develop measures are run on an open and transparent basis, with NICE committee meetings held in public. NICE also ran a public consultation during February 2012 on the proposed CCG level indicators and HSCIC gathered feedback from clinicians and commissioners on the feasibility of the indicators.

NICE published its first recommendations for the NHS England on 1 August 2012. NHS England then ran a series of engagement events in August and September 2012 for key stakeholders including voluntary groups, patient representatives, CCGs and providers. These were well attended.  

Consultation and engagement events also took place late in 2011 and early in 2012. NHS England made its final decision in November on the content and balance of measures for 2013/14, taking into account feedback from engagement events with CCGs and stakeholders and the fit with the Secretary of State’s Mandate.

The CCG Outcomes Indicator Set is designed to include outcomes achieved through a combination of good provision of GP services and good commissioning of wider healthcare services. 

It includes a number of NHS outcomes framework indicators that are shared between the NHS and public health or for which there are complementary measures in the adult social care outcomes framework, to support better integration with public health and social care.  

Services commissioned directly by NHS England such as dentistry, and specialised services are not included. We will publish separate information on quality and outcomes for these areas.

The majority of the CCG Outcomes Indicators are related to the NHS outcomes framework. A subset of these is also referenced in NHS England’s planning guidance.  

The Indicator Set does not set thresholds or levels of ambition for CCGs. Instead, it is intended to support them in determining local priorities and levels of ambition with their health and wellbeing boards (HWBs). NHS England has also provided CCG and HWB outcomes support packs with comparative data at CCG and local authority level. These packs include benchmarking information relating to the CCG Outcomes Indicator Set, where available.

It is likely that the process for developing the next indicator set for 2014/15 will follow a similar sequence to last year. NICE ran an open consultation during February 2013 on an initial list of indicators to be developed from their quality standards (see pages 41 and 42). 

Working with HSCIC, NICE will refine these and, following a meeting of its advisory committee in the summer, publish its recommendations to NHS England in August.  

NHS England will make final decisions on the content for 2014/15 later in the autumn of 2013, taking into account priorities identified through NHS outcomes framework, the Mandate and domain work streams.

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