Commissioning guides
Published 01 December 2011

Guide for commissioners on end of life care for adults

This is an extract from the commissioning guide. The complete commissioning guide is available at www.nice.org.uk/guidance/cmg42

7 Further Information

Table 8 summarises national drivers that are relevant to commissioning end of life care services for adults. Local service redesign may address only one or two of them.

Table 8 National policy on end of life care

Document

Author

Year

Significance

NHS Outcomes Framework 2012/13

Department of Health

2011

Domain 4: ensuring that people have a positive experience of care. This includes indicator 4.6 which will be derived from the survey of bereaved relatives (see section 1.6).

NICE quality standard for end of life care for adults

National Institute for Health and Clinical Excellence

2011

The Quality Standard sets out markers of high-quality care

Quality, innovation prevention and productivity (QIPP)

Department of Health

2011

End of life care QIPP workstream

Transparency in outcomes: a framework for adult social care

Department of Health

2011

All four domains of the framework have relevance with end of life care (see section 1.6)

NHS operating framework for 2012/13

Department of Health

2011

QIPP is highlighted in 2011/12 operating framework as continuing to be important for 2011/12 financial plans.

Information and links for professionals who support people and their families at the end of life

Social Care Institute for Excellence

2011

SCIE have produced a resource for people who work with adults who are approaching the end of life. It aims to provide access to tools and resources to assist professionals in providing high-quality end of life care.

End of life care strategy: third annual report

Department of Health

2011

Includes a chapter about commissioning end of life care and includes service model examples

Commissioning End of Life Care: initial actions for new commissioners

National End of Life Care Programme / National Council for Palliative Care / National End of Life Care Intelligence Network (NEoLCIN) / Dying Matters Coalition

2011

Helps commissioners to identify the immediate priority actions to commission effective end of life care.

Critical success factors that enable individuals to die in their preferred place of death

National End of Life Care Programme

Expected February 2012

Presents an analysis of the critical success factors in improving end of life care

Using the Commissioning for Quality and Innovation (CQUIN) payment framework – a summary guide

Department of Health

2010

Makes a proportion of providers' income conditional on quality and innovation.

End of life care strategy: quality markers and measures for end of life care

Department of Health

2009

Supports implementation of the End of life care strategy.

End of Life Care Strategy - promoting high quality care for all adults at the end of life

Department of Health

2008

DH strategy which commissioners and providers should be aspiring to.

Useful sources of information for developing a service specification may include:

General information on quality and corporate assurance can be obtained from the following sources:

  • Indicators for Quality Improvement Programme from the NHS Information Centre. A resource of robust indicators to help local clinical teams select indicators for local quality improvement and a source of indicators for benchmarking.

  • NHS Alliance online resources. NHS Alliance is the representational organisation of primary care and primary care trusts, and provides them with an opportunity to network and exchange best practice. The alliance supports its members with an open-access helpline, in-house and joint publications and briefings, internal newsletters and a website.

  • NHS Institute for Innovation and Improvement support for commissioners, includes products; The Productive Leader programme to enable leadership teams to reduce waste and variation in personal work processes, and 'Better care, better value indicators' to help inform planning, to inform views on the scale of potential efficiency savings in different aspects of care, and to generate ideas on how to achieve these savings

  • QOF is a voluntary quality incentive scheme that rewards general practices for implementing systematic improvements in the quality of patient care.

  • Skills for health works with employers and other stakeholders to ensure that those working in the sector are equipped with the right skills to support the development and delivery of healthcare services.

Sources of further information to help you in assessing local health needs and reducing health inequalities include:

  • The National End of Life Care Intelligence Network provide a wealth of resources including local profiles and a compendium of data sources.

  • NHS Evidence provides free access to clinical and non-clinical information - local, regional, national and international. Information includes evidence, guidance and Government policy.

  • Department of Health Delivering quality and value – focus on benchmarking.

  • NICE Health equity audit – learning from practice briefing.

  • NHS Comparators provides comparator data for NHS commissioning and provider organisations to enable users to investigate aspects of local activity, costs and outcomes.

  • The Disease management information toolkit is a good-practice tool for decision-makers, commissioners and deliverers of care for people with long-term conditions, which presents data on conditions that contribute to high numbers of emergency bed days. It models the effects of possible interventions that may be commissioned at a local level and helps users to consider the likely impact of commissioning options.

  • PARR (Patients at risk of rehospitalisation) is a risk-prediction system for use by primary care trusts to identify people at high risk of hospital re-admission.

  • PRIMIS+ provides support to general practices on information management, recording for, and analysis of, data quality, plus a comparative analysis service focused on key clinical topics.

  • The SHAPE (Strategic health asset planning and evaluation) application provides support to strategic health authorities and primary care trusts on strategic planning across a whole health economy.