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QIPP Quality, innovation, productivity and prevention - announced in June 2009 by the Chief Executive of the NHS.  This will be the next phase of the Darzi  Review and will be led personally by the Chief Executive.  He will be supported by a new NHS National Director for Improvement and Efficiency (Jim Easton).  The challenge, in times of economic downturn, is to improve  quality whilst improving productivity (more and different for less).    The respiratory community will need to rise to the challenge of finding reliable and sustainable ways to do this.  System-wide networks and shared analysis of the data will be a good place to start.   Quality Central to High Quality Care For All is improving quality which it defines in three dimensions: ensuring that care is safe, effective, and provides patients with the most positive experience possible.  The principles of how this will be achieved are also listed: Co-production – implementation should be discussed and decided in partnership with the NHS, Local Authorities and key stakeholders;   Subsidiarity – where necessary, the centre will play an enabling role, but wherever possible, the details of implementation will be determined locally;   Clinical ownership and leadership – all  staff must continue to be active participants and leaders as the work progresses;   System alignment – in doing this work people should ensure that the whole system is aligned around the same vision, allowing them to use their combined leverage at every level to drive up quality.  The National Quality Board is leading on the quality agenda, which is described by a framework pyramid model: at the base are local clinical initiatives to improve services; then provider services will publish quality accounts ; then there is the regional activity, to enable benchmarking, using services from the Quality Observatory; and finally, at the top of the pyramid are national priorities and reporting, overseen by the National Quality Board. Related Words  CQUIN Commissioning for higher quality and innovation; National Quality Board; QIPP; Quality Accounts ; Quality and outcomes framework (QOF); Quality Standards Quality Accounts The Health Act 2009 requires acute, mental health, learning disability and ambulance services to make publicly available from April 2010 a Quality Account just as they publish annual financial accounts. As of February 2010, what will be included, timings and how they will be scrutinised remain a matter for debate but consultation has ended.  The duty to publish quality accounts will apply to primary care and community services in 2011.  The framework and toolkit was published in February 2010 and is available here. Related Words  Operating Framework; Quality Quality and outcomes framework (QOF) This is part of the GP contract aimed to incentivise practices to provide systematic care for people with long term conditions. Participation is voluntary but most practices participate because it carries significant funds with it for achievement of QOF targets. It has also raised the standard of record-keeping in many places and enabled the development of disease registers for COPD and asthma. However these registers are only as good as the accuracy of the diagnosis. PCOs analyse QMAS (see below) data to determine the level of achievement against the indicators. Practices score points up to a maximum of 1050 points (in 2011 a point will be worth £130.51). The fourth edition of indicators were announced on 11 March and were advised by NICE that took responsibility for review from 2010.  Particularly relevant to respiratory care are clinical indicators for COPD and asthma and points for annual recording of smoking status. Appendix 1 to this glossary describes these clinical indicators and is worth reading. The PCRS-UK and BTS contribute to the development of new QOF standards in asthma and COPD. From 2011 for the first time there are indicators for quality and productivity.  See Appendix 1. Related Words  National Quality Board; Quality Quality Management and Analysis System (QMAS) This is the IT system used to give PCTs/Health Boards and GPs in England and Scotland feedback on practice performance against the QOF in the GMS contract.  It is used to calculate what GPs will be paid under the GMS contract.  In Wales MSDs Contract Manager is used, and in Northern Ireland the Payments Calculation and Analysis System (PCAS) is used.     Quality observatory Part of the national quality agenda. 1 quality observatory per Strategic Health Authority will be a centre of expertise that will play a key role in driving up quality across the region through support and indicator development and assistance with quality accounts. They directly link in with the Measuring for Quality Improvement programme. Related Words  National Quality Board; QIPP; Quality; Quality Accounts ; Quality and outcomes framework (QOF); Quality Standards; Strategic Health Authority (SHA) Quality Standards Part of the NHS Quality Agenda 2009. A NICE quality standard (qualitative statements with quantitative measures) is a set of specific, concise statements that: act as markers of high-quality, cost-effective patient care across a pathway or clinical area; are derived from the best available evidence; and are produced collaboratively with the NHS and social care, along with their partners and service users. NICE will be producing about 20 per year. Four pilots will be complete by March 2010: stroke care, specialist neonatal care, VTE prevention and dementia. Where possible NICE clinical guidelines will be used as the basis for these pilots. Related Words  National Quality Board; QIPP; Quality; Quality Accounts ; Quality and outcomes framework (QOF)