England

Future Forum

For the latest recommendations from the independent Future Forum to the Government and the Government response see

http://healthandcare.dh.gov.uk/forum-report/ This includes a paper on Integrated Care, recommending many initiatives favoured by IMPRESS including Year of Care approaches and tariffs, personalised care planning, personal health budgets, clarification about rules for competition and cooperation and the importance of professional bodies leading communities of practice.  The paper on Public Health recommends "Every healthcare professional should make every contact count" and suggests a priority to tobacco control and stop smoking in the first instance.

 

Outcomes Framework

20 December 2010 NHS Outcomes Framework was published.  This framework follows from the consultation Transparency in outcomes framework for the NHS.

Domains

Domain 1 Preventing people from dying prematurely

Overarching indicator
1a Mortality from causes considered amenable to healthcare 

Improvement areas
1.2 Under 75 mortality rate from respiratory disease* *Shared responsibility with Public Health England - including children (excluding pneumonia and influenza)

1.4 v One and vi five year survival from lung cancer

Domain 2 Enhancing quality of life for people with long-term conditions

Overarching indicator
2 Health related quality of life for people with long term conditions (EQ5D) 

Improvement areas
Ensuring people feel supported to manage their condition 
2.1 Proportion of people feeling supported tomanage their condition  (also included in Adult Social Care Outcomes Framework) (GP survey)

Improving functional ability in people with longterm conditions 
2.2 Employment of people with long term conditions (Labour Force Survey)

Reducing time spent in hospital by people with long term conditions 
2.3.i Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) New indicator
2.3.ii Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s

Enhancing quality of life for carers 
2.4 Health related quality of life for carers (EQ5D) GP survey

Guided by NICE COPD Quality Standard

Domain 3 Helping people to recover from episodes of ill health or following injury

Overarching indicators
3a Emergency admissions for acute conditions that should not usually require hospital admission
3b Emergency readmissions within 28 days of discharge from hospital

Improvement areas
Preventing lower respiratory tract infections (LRTIs) in children from becoming serious
3.2 Emergency admissions for children with LRTIs (indicator of effectiveness of NHS in managing LRTIs)

Helping older people to recover their independence after illness or injury 
3.6 The proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into rehabilitation services


Domain 4 Ensuring that people have a positive experience of care

Overarching indicators
4a Patient experience of primary care (GP Patient Survey)
4b Patient experience of hospital care (Inpatient Survey plus new surveys Outpatients and A&E Surveys)

Improving the experience of care for people at the end of their lives
4.6 An indicator needs to be developed based on the survey of bereaved carers  (new survey tool being developed for use in 2012/13

Domain 5 Treating and caring for people in a safe environment and protecting them from avoidable harm

Overarching indicators
5a Patient safety incident reporting 
5b Severity of harm 
5c Number of similar incidents 

Improvement areas
Reducing the incidence of avoidable harm 
5.4 Incidence of medication errors causing serious harm

Summary

Public Health

The future of Public Health in England  is described in the 2010 policy document  Healthy lives, healthy people: our strategy for public health in England. The document promises to put significant control of public health, including ring-fenced funding, in the hands of local authorities.  Much of the DH focus will move to public health and a dedicated new public health service, Public Health England", will be accountable to the Secretary of State for Heath.  Its role will be to  "fund those services that contribute to health and wellbeing primarily by prevention rather than treatment aimed at cure ... for funding and ensuring the provision of services such as health protection, emergency preparedness,  and some elements of the GP contract (including the Quality and Outcomes Framework (QOF)) such as those relating to immunisation, contraception, and dental public health."

 

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