Article
A national programme of guideline based performance measures: the UK Quality and Outcomes Framework 2009–2011
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Authors
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T. Stokes
- National Institute for Health and Clinical Excellence (NICE), Manchester, UK
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D. Sutcliffe
- National Institute for Health and Clinical Excellence (NICE), Manchester, UK
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H. Lester
- School of Health and Population Sciences, University of Birmingham, Birmingham, UK
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J. Hutton
- York Health Economics Consortium, University of York, York, UK
| Published: | July 10, 2012 |
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Outline
Text
Background: The need to link clinical guidelines to incentives for performance is increasingly being recognised at international level. The UK has two high quality national guideline programmes: NICE and SIGN and since 2004 has had a major pay-for-performance scheme for securing higher quality primary care: the Quality and Outcomes Framework (QOF) which rewards performance against criteria in 4 areas: clinical and health improvement, organisational, patient experience and additional services. NICE was given the role of developing and reviewing the QOF clinical and health improvement indicators from April 2009 with the aim of ensuring relevant evidence-based guideline recommendations are used to inform the development of indicators that are clinically effective and cost effective.
Objectives: To describes experience to date (2009–2011) in terms of developing potential QOF indicators.
Methods: A review of outputs at each stage of the QOF indicator development process.
Results: A total of 42 potential QOF indicators have been developed using the new process and of these 22 (52%) have been implemented nationally. There is a high attrition rate of relevant clinical guideline recommendations as they go through the QOF development process with approximately a third (29%, 46/153) being progressed for indicator development. The reasons for this will be presented.
Discussion: The key issues national guideline developers need to consider when linking their work to performance measures 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 performance measure development.
