Calculating Quality Reporting Service – an introduction Chris Brown CQRS Design, Build and Test Project Manager 05 September 2012

Introduction 1 Guide to this presentation This presentation will: 1.Introduce you to the principles behind CQRS and the reasoning behind introducing the Service and the benefits 2.Introduce you, at a high level, to our partner projects – GPES and SSD 3.Advise you of the reasons why the existing QMAS systems is to be replaced 4. Introduce you, at a high level, to the new functionality that CQRS will provide 5.Advise you on when CQRS will come in to service 6.Give you a little more information on how we’ll deal with Quality Indicators and COF

Introduction 2 The Health and Social Care Act outlined changes to the organisation structure, commissioning arrangements and quality outcome related payments in the NHS. The DH commissioned a project to replace the old payment system with one that could adapt to the organisational structure and payment changes. The new service, CQRS has a generic calculating tool that is envisaged to be quick and cost effective to change. The service delivery date is April 2013 for a contract that runs to July 2018.

What is CQRS? CQRS is a new payment service that is currently in development and will be in place to calculate payments for GP practices across England for the 2013/14 financial year. The service will calculate achievement and payments on quality services delivered by GP practices, including Quality Outcomes Framework (QOF), nationally-commissioned enhanced services (for example clinical Direct Enhanced Services) and services commissioned locally from GP practices that go beyond the scope of their GP contract. CQRS will use QOF and COF data supplied by the Health and Social Care Information Centre (HSCIC), including data from the General Practice Extraction Service (GPES).

General Practice Extraction Service (GPES) GPES will aim to centralise data query and extraction services, removing the complex scheduling processes and reducing the burden on practice staff. A requirement of GPES is to form part of the new process to provide payments to GPs and Clinical Commissioning Groups. GPES will not calculate payments, this will be done by CQRS. Further information on the GPES service will be available by clicking on the following link: development/general-practice-extraction-service-gpes

General Practice Extraction Service (GPES) cont GPES will be the primary source of achievement data for CQRS, but other data will also be provided by the HSCIC. CQRS will tell the HSCIC which services are being participated in and this data will be provided to GPES by the GP system suppliers. The HSCIC will provide data from other sources as required (such as information about hospital and community services for the COF). Data will be provided to CQRS on at least a monthly basis.

Why move to a new payment service? The Quality Management Analysis System (QMAS) was developed to support Quality Outcomes Framework payments (QOF) for the new GP contract in QMAS makes accurate payments for the QOF but major elements of the system are not available to users for a large part of the year. There is no national calculating system for Directed Enhanced Services (DES), Childhood Immunisation and Vaccinations. The existing arrangements to calculate performance and payments will not be able to support the new Government policy and changes to organisational structure and commissioning arrangements.

When will CQRS be in place? The service will go live in April CQRS training will happen at two periods within the implementation of the new service. Initial training will be offered prior to system implementation, starting in Autumn 2012, and will provide high-level information on workflows and functionality. The remaining training will be offered near to the implementation and will be offered at a variety of dates and times, as well as delivery methods. These dates may be subject to change.

Quality Indicators NICE are now responsible for the development and recommendation of clinical indicators for QOF. DH has also asked NICE to develop indicators for the NHSCB to consider for the Commissioning Outcomes Framework. The Health and Social Care Information Centre (HSCIC) will be involved in their development to obtain an early understanding of the data extraction requirements. Any NICE recommended indicators not negotiated into the national QOF will be available to be used locally as Local Quality Indicators = LQIs

Commissioning Outcomes Framework The purpose of this framework is to: Enable the NHS Commissioning Board to hold CCGs to account for improving quality Allow CCGs to demonstrate to patients and the public their achievements in improving quality Allow CCGs to identify and benchmark their progress

What’s new - Key CQRS functionality and terms Quality Services (QS) - CQRS uses the term ‘Services’ rather than payments. This allows for services to be supported that do not result in a direct payment to the service provider any service can be supported provided that it follows given data collection and calculation principles (the building blocks explained before) Organisations - CQRS supports any generic hierarchical organisation structure. They can be a Commissioning Organisation, Managing Organisation or a Service Provider The role an organisation performs for each Service in CQRS is defined in the participation agreement for the QS

What’s new - Key CQRS functionality and terms cont Participation CQRS records the services that an organisation has commissioned from a service provider A commissioning organisation can see all of the services that its service providers are participating in, not just the ones it has commissioned, but it cannot see the unapproved achievement data. A service provider can only see the services it is participating in..

How CQRS Supports Quality Services For service providers: Once the QOF has been negotiated and determined for the financial year it will be made available on CQRS. This means that the NHS Commissioning Board can offer the Quality Service to Service Providers. Service Providers can then decide whether to accept or reject the offer to participate in the QOF for that financial year. At any point Service Providers can view the details of the QOF, such as the indicators, and their thresholds and points on the CQRS system.

What are the benefits of CQRS? Time saving - CQRS will save both commissioning organisations and service providers time through the automation of recording, checking, submitting and approving achievement for the quality services it supports. Flexibility - The new service can be changed centrally to ensure that it is in line with new NHS requirements. Sharing best practice - CQRS will make it easier to improve quality by making the services it supports visible. This will lead to re-use of good practices and improvement in the consistency in the recording of data.

What are the benefits of CQRS? Cont. Timely - CQRS will be available for longer periods of time, particularly at the beginning of financial years. This will allow for timely data submission and earlier measurement of achievements. Achievement recording - Service providers can make use of data already extracted from relevant NHS systems to provide the data required for the outcomes frameworks. This will reduce time users spend to measure the amount of work done for services. Made with the user in mind - We have a strong working relationship with the CQRS End User Working Group and have incorporated their feedback into the requirements of the service.

How will training be conducted? CQRS users will receive training in a variety of formats which will include train-the-trainer modules, web conferencing and seminars. The following materials will be available online: Simulation tutorial Online Training Modules Job aids Training version of CQRS User Guide There will also be a dedicated helpline for users to call if they are having any issues relating to the service.

Further information Want to know more about CQRS ? Visit the CQRS website: Sign up to the CQRS bulletin for regular updates on the service: rupdates Send any further queries to: