gms | German Medical Science

Background: The need to commission health care based on its potential to improve health outcomes, as opposed to commissioning health care activity, is a national priority for the NHS in England and Wales. In 2011 NICE was tasked to develop a Commissioning Outcomes Framework (COF): an accountability framework that uses performance measures (PMs) to assess the quality of care (including health outcomes as well as processes of care) that are achieved by commissioners of care. The PMs are largely guideline derived, being developed from NICE Quality Standards and other evidence sources.

Objectives: To describe the process of developing PMs for the COF and to summarise experience to date.

Methods: NICE has developed a process for developing COF PMs and has established an independent COF Advisory Committee which met in Autumn 2011 and Spring 2012. COF PMs are currently in development across a range of chronic disease areas including Diabetes, Dementia, Stroke and COPD.

Results: An overview of the NICE COF programme, how clinical guidelines, quality standards and other evidence sources are used to inform PM development and methodological issues encountered with the first cycle of NICE COF PM development will be presented.

Discussion: The key issues national guideline developers need to consider when linking their work to PMs for health care commissioners will be discussed.

Implications for guideline developers/users: Clinical guideline recommendations need to be developed in such a way as to maximise their potential for use in subsequent PM development.