Agenda item 2013/21 DATE OF GOVERNING BODY MEETING: Category of Paper Governing Body Lead: Decision and Approval
Dr Akram Khan Clinical Board Lead Position Statement
Dr. Ishtiaq Gilkar Paper Author: Information
Tracy Gaston CCG Pharmacist Paper Title: Confidential Discussion
Prescribing Incentive Scheme SUMMARY
For many years high quality prescribing has been incentivised through a reward scheme. Typically the scheme changes each year to ensure continuous improvement is incentivised.
Schemes usually identify areas where practices are outliers within national benchmarks or where there is variation or clear room for improvement.
The proposed scheme has ten key prescribing performance indicators(KPPIs) and sets out a target for each one.
The KPPIs reflect quality and/or efficiency savings.
To achieve the reward payments practices have to demonstrate that they have fulfilled the criteria set within the indicators. Some indicators stand alone. Others are grouped together. All indicators within a group have to be achieved in order to gain points.
Some markers are carried over from last year’s scheme with slight modifications, numbers 1, 2 and 3. Others, 4 and 5 cover areas from the 2012/13 scheme but from a different angle and the remainder are new.
The majority are in line with nationally published recommendations from the National Prescribing Centre and Scottish Therapeutic Indicators(exceptions being 4,5 and 9)
KPPIs have for a number of years been used to promote quality and productivity in primary care prescribing. They have been important in the delivery of QIPP savings. NHS Bradford City CCG has a good record on delivering on the markers with improvements being made as the year progresses. IMPACT ON STRATEGIC OBJECTIVES
The KPPIs support our overall strategic objectives, specifically patient safety, and improving quality in primary care. FINANCIAL IMPLICATIONS
There are potential savings of approximately £810,000 for both City and District CCG’s. The cost of the scheme for City will be a maximum of £237,000 with potential saving of £210,000. Practices are awarded a maximum of £2 per patient, achieved from 20p per patient per marker reached. COMMUNICATIONS AND INVOLVEMENT
The indicators have been developed by the CCG Prescribing Group having taken feedback from Practices through prescribing visits, cluster meetings, practice workshops, forums etc. EQUALITY IMPACT ASSESSMENT
There are no adverse impacts on any patient groups as a result of this incentive scheme. Practices have been invited to contribute through the Prescribing Group in developing these indicators. RECOMMENDATION The Governing Body is invited to approve the prescribing incentive scheme for APPENDICES
Appendix 1 The prescribing incentive scheme summary and rationale. Back ground reading available to governing body members.
No prescriptions for combination products after 30th June 2013
a) Ezetimibe as a % ≤ 2% of all statin
b) Rosuvastatin as a ≤ 4% of all statin % of the total statin
c) No prescriptions of Omacor after 30th June 2013
with comments by the team for all items over £200 and justification if special to continue
continued only if the
person shows a reduction in HbA1c of at least 5.5 mmol/mol (0.5%) at six months.
appropriate, revise prescribing of antidepressants in adults to ensure that it is in line with NICE guidance.
7. ONDE E COMO DEVO GUARDAR ESTE MEDICAMENTO? O fumarato de quetiapina deve ser mantido em temperatura ambiente (15ºC a 30°C). Todo medicamento deve ser mantido em sua embalagem original até o momento do uso. fumarato de quetiapina TODO MEDICAMENTO DEVE SER MANTIDO FORA DO ALCANCE DAS CRIANÇAS. INFORMAÇÕES TÉCNICAS AOS PROFISSIONAIS DE SAÚDE IDENTIFICAÇÃO DO MEDICAMENTO Com
CANADIAN CORONARY ARTERY BYPASS GRAFT (CABG) SURGERY QUALITY INDICATORS (This was funded by a grant from the Heart and Stroke Foundation of Ontario-HSF5484) APPENDIX OF DEFINITIONS *Those indicators recommended by the consensus panel members to be collected and included in CABG surgery performance reports for the purpose of quality improvement. The remaining indicators were rat