SCHEDULE 2 – THE SERVICES - Bailey & Moore



SCHEDULE 2 – THE SERVICESService SpecificationsService Specification No.The format for identifying service specifications could follow: Locality/Year drafted/Treatment specialty/Sequential number/Version number. For example COPD would be X/2019/340/01/1.0Details on the numbering is as set out in Appendix 1.ServiceName service is generally known by – check for different names in different organisations. The level at which services are specified will depend on the particular service. For example, for acute hospital services, it is unlikely that you would wish to specify at HRG level. On the other hand, a specification which covers ‘all elective services’ is unlikely to be appropriate. It may also be appropriate to consider whether developing a specification on the basis of a care pathway would be missioner LeadNamed lead for service from commissioner(s). We recommend using the post-holder title rather than a named current postholder to reduce the need for amending/updating.Provider LeadNamed lead for service from provider(s). We recommend using the post-holder title rather than a named current postholder to reduce the need for amending/updating.PeriodThis is the period that you expect the specification to be valid for. In practice, this will be the same as the duration of the contract but can be shorter if required. Alternatively, you may wish to indicate that the specification is likely to be valid for a longer period, for example 3 years (subject to any procurement and competition considerations).Date of ReviewThis should be no less than 6 months before the end of the Period as stated above- there may be issues of notice to be considered. If you wish to review the specification mid-contract, then a date by which the specification is to be reviewed should be inserted here. Otherwise, as above, the specification will remain valid until the expiry/termination of the contract.1.Population NeedsNational/local context and evidence baseThis section should set the context for the service being commissioned, by setting out the evidence base for why this service is being commissioned for the local population.National context – This sets out the national NHS agenda and strategic context regarding this service. Include key points from any national reviews on the service, e.g. for ED you could cite “Safer Faster Better”, a national report which sets out the framework and principles for improving urgent care services. Local context – This describes why the service needs to be commissioned locally and what patient need/demand is being met in doing so. Include local reviews, such as those by Networks, particularly where it provides a stocktake of the current service provision. Include STP reviews where sufficiently detailed.Evidence base – usually covered in the national context, you should include the relevant national reviews of the evidence to set out why the service should be commissioned in this way. Note – no need to repeat the content of Applicable Service Standards (section 3) – differentiate between Evidence (why) and Standards (how).Background and current service provision – This sets out the service currently being provided to the local population. Refer to recent activity/quality/finance data to set the context and scale (last 3 years if possible). Include summary analysis from local reviews of where specific improvements are required, setting out key recommendations.2.Scope2.1Aims and objectives of serviceA brief description of the aims and/or objectives of the service. Ideally, the ‘aim’ should be a single sentence setting out the mission statement for the service. The objectives should be around 5-10 bullet points, setting out the main goals that the service aims to achieve. One concise example is from the specialised commissioning spec for cardiac electrophysiology and ablation:AimsThe aim of the service is to provide timely diagnosis and appropriate treatment to patients affected by symptomatic fast heart rhythms to reduce morbidity and, for a cohort of patients, reduced mortalityObjectivesEP and ablation services are designed to provide the following services in order to fulfil this aim. High quality EP and ablation services should provide the following:Assessment of patients with heart rhythm problems to establish whether or not the condition is life-threatening, and therefore whether urgent treatment is needed.Following this initial assessment, immediate treatment of any potentially life-threatening conditions with medical therapy, ablation or ICD therapy.For non-life-threatening conditions, most patients are treated with medication on an initial basisFor symptomatic patients either not controlled with medication or experiencing side effects from medication, EP ablation services provide an assessment about the suitability of ablation.Perform EP / ablation procedures with ongoing audit of performanceIt may be appropriate to clarify what the service will not do as well as what it will – e.g. “This service is not a crisis response service. It is not for families who are separating, or divorcing, or for children with existing mental health conditions.”2.2Service description/care pathwayA brief description of the service model being commissioned, including how it sits within the broader care pathway – which may include other providers. Wherever possible include a map of the pathway setting out:HOW do they get into/discharged from the service?WHAT is the process to deliver the service, such as pathway stages and options? 2.3Population coveredA description of the section/cohort of the population that the service serves e.g. adult vs children – no need to repeat the CCG’s responsible population as that always applies and the spec would normally apply to associate commissioners as well. This section is particularly applicable where the service is not subject to patient choice and the service is restricted to a defined population.e.g. “The service is accessible to all adult patients with a suspected or known rheumatological condition regardless of sex, race, or gender.”2.4Any acceptance and exclusion criteria and thresholdsSet out any specific clinical criteria used to manage referrals into the service. Refer to any specific commissioning/IFR policies that will be included in the contract at Schedule 2G, e.g. those listed on the commissioner website2.5Interdependence with other services/providersWhere the service forms part of a wider care pathway, how the service links into and works with other services and/or providers is identified here. If it is complex, a diagram/map representation may be easier to set this out, rather than a textual description.3.Applicable Service Standards3.1Applicable national standards (e.g. NICE)List any national service standards published by the NHS/NICE that apply to this service and the provider will be held accountable for complying with. The evidence base is set out in section 1.3.2Applicable standards set out in Guidance and/or issued by a competent body (ego Royal Colleges)List any national service standards published by other relevant bodies that apply to this service and the provider will be held accountable for complying with.3.3Applicable local standardsList any local service standards published by the STP/commissioners that apply to this service and the provider will be held accountable for complying with.4.Outcomes, KPIs and CQUIN goals4.1Outcomes and Quality Requirement KPIs by NHS Outcomes Framework Domain:When drafting this section, start with the 5 National Domains, then add any appropriate Overarching Indicators and Improvement areas from NHS Outcomes Framework. These are shown at Appendix 2 (August version) as an example. Finally, add any Local indicators, i.e. locally defined and measured.Note that this section is used to list:The main patient outcomes required from the service. Non-patient outcomes should not be included here, e.g. where submission of specific data or reports is a desired outcome this can be included in section 7 below.The quality requirement/KPIs for each outcome, i.e. how will achievement of the outcome be measured? These need to be match exactly the quality requirements included in the contract at schedules 4A-4C.The threshold for achievement – i.e. what the provider will be measured against, remembering that some is not a number, soon is not a time!How the data to measure achievement will be collected – this needs to cross-refer to contract schedule 6A (reporting requirements) to check this data is being requested from the provider and to what timescale etc.The consequence of any failure to meet the KPIs defined andHow frequently this consequence will be measured and contractually appliedAn example of how these might work is as shown below for cardiac rehab.“It is reasonable for specific financial consequences to be agreed for non-achievement, so long as these are proportionate. Regardless of whether specific financial consequences have been agreed in relation to Local Quality Requirements, commissioners may of course use the contract management process set out in GC9 to address any breaches – see paragraph 45 below. Where no specific financial consequences are agreed for a Local Quality Requirement, the words ‘Issue of a Contract Performance Notice and subsequent process in accordance with GC9’ should be inserted as the relevant consequence in Schedule 4C.” (Technical Guidance para 39.9)Domain 1: Preventing people from dying prematurelyOutcomeRefQuality Requirement/KPIThresholdMethod of MeasurementConsequence of breachTiming of measurementNational Indicator/improvement areaReducing premature mortality rate from cardiovascular disease1.1Under 75 mortality rate from cardiovascular disease70.8 per 100,000 (national av)NHSOF annual indicator GC9 process followedAnnuallyLocal outcomes & indicatorsReduced Admissions – reduction in readmissions for another cardiac eventL1.1Readmission rate10% reductionSUS monthly extractsGC9 process followedQuarterlyDomain 2: Enhancing quality of life for people with long-term conditionsOutcomeRefQuality Requirement/KPIThresholdMethod of MeasurementConsequence of breachTiming of measurement National Indicator/improvement areaLocal outcomes & indicatorsDomain 3: Helping people to recover from episodes of ill-health or following injuryOutcomeRefQuality Requirement/KPIThresholdMethod of MeasurementConsequence of breachTiming of measurement National Indicator/improvement areaLocal outcomes & indicatorsDomain 4: Ensuring people have a positive experience of careOutcomeRefQuality Requirement/KPIThresholdMethod of MeasurementConsequence of breachTiming of measurement National Indicator/improvement areaLocal outcomes & indicatorsDomain 5: Treating and caring for people in safe environment and protecting them from avoidable harmOutcomeRefQuality Requirement/KPIThresholdMethod of MeasurementConsequence of breachTiming of measurement National Indicator/improvement areaLocal outcomes & indicators4.2 Applicable CQUIN goalsWhere any CQUIN goals apply to the service, whether national or local schemes, these should be listed here. These will cross-refer to contract schedule 4D.5.Location of Provider PremisesThe Provider’s Premises are located at:This section is only needed where it is considered important to specify that a service is provided from a particular location (or where services are to be provided within a certain area, or easily accessible from it) and therefore there is a need to list specific provider premises. Otherwise it can be left blank. For example:A certain locality may find it difficult to access the service because of its location and the commissioners wish to specify that the provider needs to provide the service at a particular site to address thisIt may be considered essential that the service is co-located with another service, e.g. level 1 adult critical care, and this is only provided at one of the provider’s premises 6.Individual Service User PlacementThis section may be used to include details of any long-term individual service user placements (or Individual Placement Agreement as described in section 27 of the Contract Technical Guidance). This is usually only relevant where the service provides tailored specialist placements. It may also be used to record any specialist equipment that is provided as part of an individual care pathway.Otherwise, this section can be left blank.7.Personalised Care RequirementsThis section may be used to include details of service-specific requirements for personalisation of care, aligned with the content of contract schedule 2M (Development Plan for Personalised Care).Otherwise, this section can be left blank.8.Reporting RequirementsList any specific reporting requirements that supply the source data needed to measure the achievement of the KPIs listed in section 4. Ultimately these will need to be incorporated into schedule 6A (reporting requirements) of the contract but can be listed here for completeness and to ensure the spec can be read more easily as a standalone document.If the requirement is a national contractual requirement, e.g. the monthly activity and finance report or the monthly Service Quality Performance Report, they do not need to be listed again in this section. These will be listed under ‘National Requirements Reported Centrally’ and ‘National Requirements Reported Locally’ in schedule 6A of the contract.Reporting RequirementReporting PeriodFormat of ReportTiming and Method for delivery of Reporte.g.:Additional Maternity Ante-natal / Post-natal Pathway Datasets To be supplied monthly until the release of the new maternity SUS datasetIndicating the split of standard, intermediate, intensive tariffs, and the backing of indicators that trigger these categories.Submit to DSCRO by no later than the First Reconciliation Date for the month to which it relates, consistent with data submitted to SUS.9.Payment MechanismSet out any local pricing arrangements or payment mechanism that applies to this service. This would cover issues such as:TypeExampleReplacing national prices with local price variations/departuresactivity recorded as an emergency admission with a length of stay under 4 hours to be charged against the blended payment at a locally-agreed unit price of ?250Local currency variationsall non-consultant led outpatients to be charged as a follow-up attendance, even if recorded as a first attendanceLocal ‘blended payment’ agreements80% of planned activity funded as a block, with 20% paid on trajectory towards achievement of outcomes in section 4Incentivise using the required pathway non-face-to-face outpatient attendances to be charged against the blended payment at 10% more than the equivalent face-to-face national priceUltimately these will need to be incorporated into schedule 3A (local prices) or 3B (local price variations) of the contract but can be listed here for completeness and to ensure the spec can be read more easily as a standalone document.The format for identifying service specifications follows the format: Locality/Year drafted/Treatment specialty/Sequential number/Version numberNameDescriptionExampleLocalityX/Y/BLocality X, Y or BothYear draftedStart year2019 etc!Treatment specialtySee list belowe.g. 340 (respiratory med)Specification identifierThere will be a number of specs within each treatment specialty e.g. Respiratory will include COPD, TB, Asthma etc. Suggest each gets its own number – but someone (contracts team?) needs to keep track!e.g. 01 for COPD, 02 for TB, 03 AsthmaVersion numberStarting from 1.0, change first number when draft issued, second for minor changes/comments/amendmentse.g. 2.1 for first draft of second version So - COPD might be X/2019/340/01/1.0Current Treatment Specialties and their national codes:CodeNameSurgical Specialties:100General Surgery Service101Urology Service102Transplant Surgery Service103Breast Surgery Service104Colorectal Surgery Service105Hepatobiliary and Pancreatic Surgery Service106Upper Gastrointestinal Surgery Service107Vascular Surgery Service108Spinal Surgery Service109Bariatric Surgery Service110Trauma and Orthopaedic Service111Orthopaedic Service113Endocrine Surgery Service115Trauma Surgery Service120Ear Nose and Throat Service130Ophthalmology Service140Oral Surgery Service141Restorative Dentistry Service143Orthodontic Service144Maxillofacial Surgery Service145Oral and Maxillofacial Surgery Service150Neurosurgical Service160Plastic Surgery Service161Burns Care Service170Cardiothoracic Surgery Service172Cardiac Surgery Service173Thoracic Surgery Service174Cardiothoracic Transplantation Service191Pain Management ServiceSpecialised Children’s Services:142Paediatric Dentistry Service171Paediatric Surgery Service211Paediatric Urology Service212Paediatric Transplantation Surgery Service213Paediatric Gastrointestinal Surgery Service214Paediatric Trauma and Orthopaedic Service215Paediatric Ear Nose and Throat Service216Paediatric Ophthalmology Service217Paediatric Oral and Maxillofacial Surgery Service218Paediatric Neurosurgery Service219Paediatric Plastic Surgery Service220Paediatric Burns Care Service221Paediatric Cardiac Surgery Service222Paediatric Thoracic Surgery Service223Paediatric Epilepsy Service230Paediatric Clinical Pharmacology Service240Paediatric Palliative Medicine Service241Paediatric Pain Management Service242Paediatric Intensive Care Service250Paediatric Hepatology Service251Paediatric Gastroenterology Service252Paediatric Endocrinology Service253Paediatric Clinical Haematology Service254Paediatric Audio Vestibular Medicine Service255Paediatric Clinical Immunology and Allergy Service256Paediatric Infectious Diseases Service257Paediatric Dermatology Service258Paediatric Respiratory Medicine Service259Paediatric Nephrology Service260Paediatric Medical Oncology Service261Paediatric Inherited Metabolic Medicine Service262Paediatric Rheumatology Service263Paediatric Diabetes Service264Paediatric Cystic Fibrosis Service270Paediatric Emergency Medicine Service280Paediatric Interventional Radiology Service290Community Paediatric Service291Paediatric Neuro-disability Service321Paediatric Cardiology Service421Paediatric Neurology ServiceMedical Specialties:180Emergency Medicine Service190Anaesthetic Service192Intensive Care Medicine Service200Aviation and Space Medicine Service300General Internal Medicine Service301Gastroenterology Service302Endocrinology Service303Clinical Haematology Service304Clinical Physiology Service305Clinical Pharmacology Service306Hepatology Service307Diabetes Service308Blood and Marrow Transplantation Service309Haemophilia Service310Audio Vestibular Medicine Service311Clinical Genetics Service313Clinical Immunology and Allergy Service314Rehabilitation Medicine Service315Palliative Medicine Service316Clinical Immunology Service317Allergy Service318Intermediate Care Service319Respite Care Service320Cardiology Service322Clinical Microbiology Service323Spinal Injuries Service324Anticoagulant Service325Sport and Exercise Medicine Service326Acute Internal Medicine Service327Cardiac Rehabilitation Service328Stroke Medicine Service329Transient Ischaemic Attack Service330Dermatology Service331Congenital Heart Disease Service333Rare Disease Service335Inherited Metabolic Medicine Service340Respiratory Medicine Service341Respiratory Physiology Service342Pulmonary Rehabilitation Service343Adult Cystic Fibrosis Service344Complex Specialised Rehabilitation Service345Specialist Rehabilitation Service346Local Specialist Rehabilitation Service347Sleep Medicine Service350Infectious Diseases Service352Tropical Medicine Service360Genitourinary Medicine Service361Renal Medicine Service370Medical Oncology Service371Nuclear Medicine Service400Neurology Service401Clinical Neurophysiology?Service410Rheumatology Service420Paediatric Service422Neonatal Critical Care Service424Well Baby Service430Elderly Medicine Service431Orthogeriatric Medicine Service450Dental Medicine Service451Special Care Dentistry Service460Medical Ophthalmology Service461Ophthalmic and Vision Science Service501Obstetrics Service502Gynaecology Service503Gynaecological Oncology Service504Community Sexual and Reproductive Health Service505Fetal Medicine Service560Midwifery ServiceTherapies:650Physiotherapy Service651Occupational Therapy Service652Speech and Language Therapy Service653Podiatry Service654Dietetics Service655Orthoptics Service656Clinical Psychology Service657Prosthetics Service658Orthotics Service659Dramatherapy Service660Art Therapy Service661Music Therapy Service662Optometry Service663Podiatric Surgery Service670Urological Physiology Service673Vascular Physiology Service675Cardiac Physiology Service677Gastrointestinal Physiology ServicePsychiatry:700Intellectual Disability Service710Adult Mental Health Service711Child and Adolescent Psychiatry Service712Forensic Psychiatry Service713Medical Psychotherapy Service715Old Age Psychiatry Service720Eating Disorders Service721Addiction Service722Liaison Psychiatry Service723Psychiatric Intensive Care?Service724Perinatal Mental Health Service725Mental Health?Recovery and Rehabilitation Service726Mental Health Dual Diagnosis Service727Dementia Assessment Service730Neuropsychiatry ServiceRadiology:800Clinical Oncology Service811Interventional Radiology Service812Diagnostic Imaging ServicePathology:822Chemical Pathology Service834Medical Virology ServiceOther:840Audiology Service920Diabetic Education ServiceSource: numberIndicatorData sourceFrequency of publicationDomain 1: Preventing people from dying prematurelyOverarching Indicators:1a.iPotential years of life lost (PYLL) from causes considered amenable to healthcare - AdultsONS avoidable mortality / ONS populations / ONS period and cohort life expectancyAnnual1a.iiPotential years of life lost (PYLL) from causes considered amenable to healthcare - Children and young peopleONS avoidable mortality / ONS populations / ONS period and cohort life expectancyAnnual1bLife expectancy at 75 - i. Male ii. FemaleONS period and cohort life expectancyAnnual1cNeonatal mortality and stillbirthsONS Child Mortality in England and WalesAnnualOutcome: Reducing premature mortality from the major causes of death1.1Under 75 mortality rate from cardiovascular diseaseONS Mortality / ONS populationsAnnual1.2Under 75 mortality rate from respiratory diseaseONS Mortality / ONS populationsAnnual1.3Under 75 mortality rate from liver diseaseONS Mortality / ONS populationsAnnual1.4Under 75 mortality rate from cancerONS Mortality / ONS populationsAnnual1.4.iOne-year survival from all cancersONS Cancer Survival for Clinical Commissioning Groups in EnglandAnnual1.4.iiFive-year survival from all cancersONS Cancer Survival for Clinical Commissioning Groups in EnglandAnnual1.4.iiiOne-year survival from breast, lung and colorectal cancerONS Cancer Survival for Clinical Commissioning Groups in EnglandAnnual1.4.ivFive-year survival from breast, lung and colorectal cancerONS Cancer Survival for Clinical Commissioning Groups in EnglandAnnual1.4.vOne-year survival from cancers diagnosed at stage 1&2To be confirmedAnnual1.4.viFive-year survival from cancers diagnosed at stage 1&2To be confirmedAnnualOutcome: Reducing premature death in people with mental illness1.5.iExcess under 75 mortality rate in adults with serious mental illnessLinked PCMD-MHMDS data / ONS Mortality / ONS populationsAnnual1.5.iiExcess under 75 mortality rate in adults with common mental illnessTo be confirmedTo be confirmed1.5.iiiSuicide and mortality from injury of undetermined intent among people with recent contact from NHS servicesTo be confirmedTo be confirmedIndicator numberIndicatorData sourceFrequency of publicationOutcome: Reducing mortality in children1.6.iInfant mortalityONS Child Mortality in England and WalesAnnual1.6.iiFive-year survival from all cancers in childrenONS Childhood Cancer Survival in EnglandAnnualOutcome: Reducing premature death in people with a learning disability1.7Excess under 60 mortality rate in adults with a learning disabilityTo be confirmedTo be confirmedIndicator numberIndicatorData sourceFrequency of publicationDomain 2: Enhancing quality of life for people with long-term conditionsOverarching Indicator:2Health-related quality of life for people with long-term conditionsGPPSAnnualOutcome: Ensuring people feel supported to manage their condition2.1Proportion of people feeling supported to manage their conditionGPPSAnnualOutcome: Improving functional ability in people with long-term conditions2.2Employment of people with long-term conditionsLFSQuarterlyOutcome: Reducing time spent in hospital by people with long-term conditions2.3. iUnplanned hospitalisation for chronic ambulatory care sensitive conditionsHES / ONS populationsAnnual2.3.iiUnplanned hospitalisation for asthma, diabetes and epilepsy in under 19sHES / ONS populationsAnnualOutcome: Enhancing quality of life for carers2.4Health-related quality of life for carersGPPSAnnualOutcome: Enhancing quality of life for people with mental illness2.5.iEmployment of people with mental illnessLFSQuarterly2.5.iiHealth-related quality of life for people with mental illnessTo be confirmedAnnualOutcome: Enhancing quality of life for people with dementia2.6.iEstimated diagnosis rate for people with dementiaQOF / Dementia UK report (2007) / ONS populations (including very elderly)Annual2.6.iiA measure of the effectiveness of post-diagnosis care in sustaining independence and improving quality of lifeTo be confirmedTo be confirmedOutcome: Enhancing quality of life for people with multiple long-term conditions2.7Health-related quality of life for people with three or more long-term conditionsGPPSAnnualIndicator numberIndicatorData sourceFrequency of publicationDomain 3: Helping people to recover from episodes of ill health or following injuryOverarching Indicators:3aEmergency admissions for acute conditions that should not usually require hospital admissionHES / ONS populationsAnnual3bEmergency re-admissions within 30 days of discharge from hospitalHES / ONS populationsAnnualOutcome: Improving outcomes from planned treatments3.1.iTotal health gain as assessed by patients for elective procedures - Physical health-related proceduresPROMsAnnual3.1.iiTotal health gain as assessed by patients for elective procedures - Psychological therapiesIAPTAnnual3.1.iiiRecovery in quality of life for patients with mental illnessTo be confirmedTo be confirmedOutcome: Preventing lower respiratory tract infections (LRTIs) in children from becoming serious3.2Emergency admissions for children with lower respiratory tract infectionsHES / ONS populationsAnnualOutcome: Improving recovery from injuries and trauma3.3Survival from major traumaTARNAnnualOutcome: Improving recovery from stroke3.4Proportion of stroke patients reporting an improvement in activity/lifestyle on the Modified Rankin scale at 6 monthsSSNAPAnnualOutcome: Improving recovery from fragility fractures3.5.iHip fracture: Proportion of patients recovering to their previous levels of mobility at 30 daysNHFDAnnual3.5.iiHip fracture: Proportion of patients recovering to their previous levels of mobility at 120 daysNHFDAnnualOutcome: Helping older people to recover their independence after illness or injury3.6.iProportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement/rehabilitation servicesASCOFAnnual3.6.iiProportion offered rehabilitation following discharge from acute or community hospitalASCOF / HESAnnualOutcome: Improving dental health3.7.iDecaying teethTo be confirmedTo be confirmed3.7.iiTooth extractions due to decay for children admitted as inpatients to hospital, aged 10 years and underHESAnnualIndicator numberIndicatorData sourceFrequency of publicationDomain 4: Ensuring that people have a positive experience of careOverarching Indicators:4a.iPatient experience of primary care - GP servicesGPPSAnnual4a.iiPatient experience of primary care - GP out-of-hours servicesGPPSAnnual4a.iiiPatient experience of primary care - NHS dental servicesGPPSAnnual4bPatient experience of hospital careInpatient survey (CQC)Annual4cFriends and Family TestF&F surveyTo be confirmed4d.iPatient experience characterised as poor or worse - primary careGPPSAnnual4d.iiPatient experience characterised as poor or worse - hospital careInpatient survey (CQC)AnnualOutcome: Improving people’s experience of outpatient care4.1Patient experience of outpatient servicesOutpatient survey (CQC)IrregularOutcome: Improving hospitals’ responsiveness to personal needs4.2Responsiveness to inpatients’ personal needsInpatient survey (CQC)AnnualOutcome: Improving people’s experience of accident and emergency services4.3Patient experience of A&E servicesA&E survey (CQC)IrregularOutcome: Improving access to primary care services4.4.iAccess to GP servicesGPPSAnnual4.4.iiAccess to NHS dental servicesGPPSAnnualOutcome: Improving women and their families’ experience of maternity services4.5Women’s experience of maternity servicesMaternity survey (CQC)IrregularOutcome: Improving the experience of care for people at the end of their lives4.6Bereaved carers' views on the quality of care in the last 3 months of lifeVOICES surveyAnnualOutcome: Improving the experience of healthcare for people with mental illness4.7Patient experience of community mental health servicesCommunity Mental Health survey (CQC)AnnualOutcome: Improving children and young people’s experience of healthcare4.8Improving children and young people’s experience of inpatient servicesTo be confirmedTo be confirmedOutcome: Improving people’s experience of integrated care4.9Improving people’s experience of integrated careTo be confirmedTo be confirmedIndicator numberIndicatorData sourceFrequency of publicationDomain 5: Treating and caring for people in a safe environment and protecting them from avoidable harmOverarching Indicators:5aDeaths attributable to problems in healthcareTo be confirmedTo be confirmed5bSevere harm attributable to problems in healthcareTo be confirmedTo be confirmedOutcome: Reducing the incidence of avoidable harm5.1Deaths from venous thromboembolism (VTE) related events within 90 days post discharge from hospitalHES-ONS / HESAnnual5.2.iIncidents of healthcare associated infection (HCAI) - MRSAPHEAnnual5.2.iiIncidents of healthcare associated infection (HCAI) - C. difficilePHEAnnual5.3Proportion of patients with category 2, 3 and 4 pressure ulcersTo be confirmedTo be confirmed5.4Hip fractures from falls during hospital careNHFDAnnualOutcome: Improving the safety of maternity services5.5Admission of full-term babies to neonatal careNNRD / ONS populationsAnnualOutcome: Improving the culture of safety reporting5.6Patient safety incidents reportedNRLS / ONS populationsBiannualSource: ................
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