Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part 2 of Module B: Never Events Never Events Threshold Method of Measurement Never Event Consequence (per occurrence) Wrongly prepared high-risk injectable medication >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of potassium-containing solutions >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration of oral/enteral treatment >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Overdose of midazolam during conscious sedation >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Opioid overdose of an opioid-naïve Patient >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Inappropriate administration of daily oral methotrexate >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Falls from unrestricted windows >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Entrapment in bedrails >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Transfusion of ABO-incompatible blood components >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Wrong gas administered >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Air embolism >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery of the cost of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-line standard template on the website of the NHS Institute for Innovation and Improvement contains some additional fields to assist its automated functions. Parties may include these additional fields in the completed version of the scheme included in the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 (BILATERAL)
Appears in 1 contract
Samples: National Variation
Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) …………………………………………………...Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) a Member, in the presence of: ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part Commissioner Requested Services and Essential Services Commissioner Requested Services Insert text locally or state Not Applicable Essential Services Insert text locally or state Not Applicable CRS Continuity Plan/Essential Services Continuity Plan Insert text locally or state Not Applicable APPENDIX 2 of Module B: Never Events Never Events National Quality Requirements National Quality Requirement Threshold (2013/14) Method of Measurement Never Event (2013/14) Consequence (per occurrence) Wrongly prepared high-risk injectable medication of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non-payment of inpatient episode Monthly A CB_A16 Rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report As set out in Section B Part 8.5 Annual A CB_S6 Zero tolerance RTT waits over 52 weeks >0 Review of monthly Service Quality Performance Report £5,000 per patient waiting over 52 weeks Monthly A. C, MH where 18 weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes Handover >15 minutes Review of monthly Service Quality Performance Report £200 per patient waiting over 30 minutes Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes Handover > 15 minutes Review of monthly Service Quality Performance Report £1,000 per patient waiting over 60 minutes (in total, not aggregated with applicable CB_S7a consequence) Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call >15 minutes Review of monthly Service Quality Performance Report £20 per event where > 30 minutes Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call > 15 minutes Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) Monthly AM CB_S9 Trolley waits in A&E Any trolley wait > 12 hours Review of monthly Service Quality Performance Report £1,000 per breach Monthly A+E CB_S10 No urgent operation should be cancelled for a second time Number of urgent operations cancelled for a second time Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non-payment/ reimbursement of costs (as applicable) of rescheduled episode of care. Monthly A, CR, C, S Failure to publish Formulary Yes/No Publication on Provider’s website Withholding of up to 1% of the monthly sums payable by the Commissioners under Clause 7 (Prices and Payment) per month until publication Monthly All Duty of Candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance, recovery ) [Insert as per local determination] Recovery of the cost of the procedure episode of care or £10,000 if the cost of the episode of care is unknown. Monthly All Local Quality Requirements Quality Requirement Threshold Method of Measurement Consequence of breach Domain 1: Preventing people dying prematurely Insert text locally Domain 2: Enhancing the quality of life of people with long-term conditions Insert text locally Domain 3: Helping people to recover from episodes of ill-health or following injury Insert text locally Domain 4: Ensuring that people have a positive experience of care Insert text locally Domain 5: Treating and no charge caring for people in a safe environment and protecting them from avoidable harm Insert text locally All sums calculated in accordance with this Section B Part 8.1 will be subject to Commissioner an annual cap of 1.0% of Actual Annual Value APPENDIX 3 Operational Standards Ref Operational Standards Threshold (2013/14) Method of Measurement (2013/14) Consequence of breach Monthly or annual application of consequence Applicable Service Category RTT waiting times for any corrective procedure or care Maladministration non-urgent consultant-led treatment CB_B1 Percentage of potassium-containing solutions >0 admitted patients starting treatment within a maximum of 18 weeks from referral Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Clause 43 and Section B Part 8.4 Monthly A. C, recovery MH where 18 weeks applies CB_B2 Percentage of the cost non-admitted patients starting treatment within a maximum of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration 18 weeks from referral Operating standard of oral/enteral treatment >0 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Clause 43 and Section B Part 8.4 Monthly A. C, recovery MH where 18 weeks applies CB_B3 Percentage of the cost patients on incomplete non-emergency pathways (yet to start treatment) waiting no more than 18 weeks from referral Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 92% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Clause 43 and Section B Part 8.4 Monthly A. C, recovery MH where 18 weeks applies Diagnostic test waiting times CB_B4 Percentage of the cost patients waiting less than 6 weeks from referral for a diagnostic test Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 99% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the month of the procedure and no charge to Commissioner for any corrective procedure under-achievement Monthly A, C A&E waits CB_B5 Percentage of A & E attendances where the patient was admitted, transferred or care Overdose discharged within 4 hours of midazolam during conscious sedation >0 their arrival at an A&E department Operating standard of 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A+E Cancer waits - 2 week wait CB_B6 Percentage of patients referred urgently with suspected cancer by a GP waiting no charge to Commissioner more than two weeks for any corrective procedure or care Opioid overdose first outpatient appointment Operating standard of an opioid-naïve Patient >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B7 Percentage of patients referred urgently with breast symptoms (where cancer was not initially suspected) waiting no charge to Commissioner more than two weeks for any corrective procedure or care Inappropriate administration first outpatient appointment Operating standard of daily oral methotrexate >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 31 days CB_B8 Percentage of patients waiting no charge more than one month (31 days) from diagnosis to Commissioner first definitive treatment for any corrective procedure or care Falls from unrestricted windows >0 all cancers Operating standard of 96% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B9 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Entrapment in bedrails >0 subsequent treatment where that treatment is surgery Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B10 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Transfusion subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of ABO-incompatible blood components >0 98% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B11 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 62 days CB_B12 Percentage of patients waiting no charge more than two months (62 days) from urgent GP referral to Commissioner first definitive treatment for any corrective procedure or care Wrong gas administered >0 cancer Operating standard of 85% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B13 Percentage of patients waiting no charge more than 62 days from referral from an NHS screening service to Commissioner first definitive treatment for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 all cancers Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B14 Percentage of patients waiting no charge more than 62 days for first definitive treatment following a consultant’s decision to Commissioner for any corrective procedure or care Air embolism >0 upgrade the priority of the patient (all cancers) [Insert as per local determination] Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In 2% of revenue derived from the provision of the locally defined service line in the quarter of the under-achievement Quarterly A, CR Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual contract monthly value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Schedule 6 Part C in accordance with applicable Guidancethe Professional Letter £250 per day per patient affected Monthly A, recovery CR, S, C, MH Cancelled operations CB_B18 All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the cost patient’s choice Number of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients patients who are not offered another binding date within 28 days >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non- payment of costs associated with applicable Guidancecancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A, recovery CR, S, C, TP Mental health CB_B19 Care Programme Approach (CPA): The percentage of people under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Report [Insert as per local determination] [Insert as per local determination] MH, MHSS APPENDIX 4 Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: Summary of goals Goal Number Goal Name Description of Goal Goal weighting (% of CQUIN scheme available) Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) 1 Friends and Family Test To improve the cost experience of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-patients in line standard template on the website with Domain 4 of the NHS Institute Outcomes Framework. The Friends and Family Test will provide timely, granular feedback from patients about their experience. The 2011/12 national inpatient survey showed that only 13 per cent of patients in acute hospital inpatient wards and A&E departments were asked for Innovation and Improvement contains some additional fields to assist its automated functionsfeedback 2 NHS Safety Thermometer To reduce harm. Parties may include these additional fields in the completed version The power of the NHS Safety Thermometer lies in allowing frontline teams to measure how safe their services are and to deliver improvement locally 3 Dementia To incentivise the identification of patients with dementia and other causes of cognitive impairment alongside their other medical conditions, to prompt appropriate referral and follow up after they leave hospital and to ensure that hospitals deliver high quality care to people with dementia and support their carers. 4 VTE To reduce avoidable death, disability and chronic ill health from venous thromboembolism (VTE) 5 6 etc Totals: 100.00% CQUIN Table 2: Summary of indicators Goal Number Indicator Number Indicator Name Indicator Weighting (% of CQUIN scheme included available) Expected financial value of Indicator (£) 1 6 etc Totals: 100.00% CQUIN Table 3: Detail of indicator (to be completed for each indicator) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to Commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to Commissioner) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment Are there any rules for partial achievement of the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 indicator at the final indicator period/date? CQUIN Table 4: Milestones (BILATERAL)only to be completed for indicators that contain in-year milestones) Goal No. Indicator No. Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to Commissioner) Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Total: CQUIN Table 5: Rules for partial achievement at final indicator period/date (only complete if the indicator has rules for partial achievement at final indicator period/date) Goal No. Indicator No. Final indicator value for the part achievement threshold % of CQUIN scheme available for meeting final indicator value CQUIN Table 6: Maximum aggregate CQUIN Payment Contract Year Maximum aggregate CQUIN Payment 2013/14 2.5% of Actual Annual Value Subsequent years To be determined nationally and inserted locally CQUIN Table 7: CQUIN Payments on Account Commissioner Payment Frequency/Timing Agreed provisions for adjustment of Payments on CQUIN Account based on performance APPENDIX 5 Surveys Type of Survey Frequency Method of Reporting Method of Publication Friends and Family Test (where required in accordance with FFT Guidance) Service User Survey [Insert further description locally] Staff Surveys [Insert further description locally] Carer Survey [Insert further description locally] [Other insert locally]
Appears in 1 contract
Samples: www.england.nhs.uk
Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) …………………………………………………...Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) a Member, in the presence of: ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part Commissioner Requested Services and Essential Services Commissioner Requested Services Insert text locally or state Not Applicable Essential Services Insert text locally or state Not Applicable CRS Continuity Plan/Essential Services Continuity Plan Insert text locally or state Not Applicable APPENDIX 2 of Module B: Never Events Never Events National Quality Requirements National Quality Requirement Threshold (2013/14) Method of Measurement Never Event (2013/14) Consequence (per occurrence) Wrongly prepared high-risk injectable medication of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non-payment of inpatient episode Monthly A CB_A16 Rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report - Annual A CB_S6 Zero tolerance RTT waits over 52 weeks >0 Review of monthly Service Quality Performance Report £5,000 per patient waiting over 52 weeks Monthly A. C, MH where 18 weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes Handover >15 minutes Review of monthly Service Quality Performance Report £200 per patient waiting over 30 minutes Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes Handover > 15 minutes Review of monthly Service Quality Performance Report £1,000 per patient waiting over 60 minutes (in total, not aggregated with applicable CB_S7a consequence) Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call >15 minutes Review of monthly Service Quality Performance Report £20 per event where > 30 minutes Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call > 15 minutes Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) Monthly AM CB_S9 Trolley waits in A&E Any trolley wait > 12 hours Review of monthly Service Quality Performance Report £1,000 per breach Monthly A+E CB_S10 No urgent operation should be cancelled for a second time Number of urgent operations cancelled for a second time Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non-payment/ reimbursement of costs (as applicable) of rescheduled episode of care. Monthly A, CR, C, S Failure to publish Formulary Yes/No Publication on Provider’s website Withholding of up to 1% of the monthly sums payable by the Commissioners under Clause 7 (Prices and Payment) per month until publication Monthly All Duty of Candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance, recovery ) [Insert as per local determination] Recovery of the cost of the procedure episode of care or £10,000 if the cost of the episode of care is unknown. Monthly All Local Quality Requirements Quality Requirement Threshold Method of Measurement Consequence of breach Domain 1: Preventing people dying prematurely Insert text locally Domain 2: Enhancing the quality of life of people with long-term conditions Insert text locally Domain 3: Helping people to recover from episodes of ill-health or following injury Insert text locally Domain 4: Ensuring that people have a positive experience of care Insert text locally Domain 5: Treating and no charge caring for people in a safe environment and protecting them from avoidable harm Insert text locally All sums calculated in accordance with this Schedule 3 Part 4A will be subject to Commissioner an annual cap of 1.0% of Actual Annual Value APPENDIX 3 Operational Standards Ref Operational Standards Threshold (2013/14) Method of Measurement (2013/14) Consequence of breach Monthly or annual application of consequence Applicable Service Category RTT waiting times for any corrective procedure or care Maladministration non-urgent consultant-led treatment CB_B1 Percentage of potassium-containing solutions >0 admitted patients starting treatment within a maximum of 18 weeks from referral Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies CB_B2 Percentage of the cost non-admitted patients starting treatment within a maximum of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration 18 weeks from referral Operating standard of oral/enteral treatment >0 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies CB_B3 Percentage of the cost patients on incomplete non-emergency pathways (yet to start treatment) waiting no more than 18 weeks from referral Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 92% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies Diagnostic test waiting times CB_B4 Percentage of the cost patients waiting less than 6 weeks from referral for a diagnostic test Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 99% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the month of the procedure and no charge to Commissioner for any corrective procedure under-achievement Monthly A, C A&E waits CB_B5 Percentage of A & E attendances where the patient was admitted, transferred or care Overdose discharged within 4 hours of midazolam during conscious sedation >0 their arrival at an A&E department Operating standard of 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A+E Cancer waits - 2 week wait CB_B6 Percentage of patients referred urgently with suspected cancer by a GP waiting no charge to Commissioner more than two weeks for any corrective procedure or care Opioid overdose first outpatient appointment Operating standard of an opioid-naïve Patient >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B7 Percentage of patients referred urgently with breast symptoms (where cancer was not initially suspected) waiting no charge to Commissioner more than two weeks for any corrective procedure or care Inappropriate administration first outpatient appointment Operating standard of daily oral methotrexate >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 31 days CB_B8 Percentage of patients waiting no charge more than one month (31 days) from diagnosis to Commissioner first definitive treatment for any corrective procedure or care Falls from unrestricted windows >0 all cancers Operating standard of 96% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B9 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Entrapment in bedrails >0 subsequent treatment where that treatment is surgery Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B10 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Transfusion subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of ABO-incompatible blood components >0 98% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B11 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 62 days CB_B12 Percentage of patients waiting no charge more than two months (62 days) from urgent GP referral to Commissioner first definitive treatment for any corrective procedure or care Wrong gas administered >0 cancer Operating standard of 85% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B13 Percentage of patients waiting no charge more than 62 days from referral from an NHS screening service to Commissioner first definitive treatment for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 all cancers Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B14 Percentage of patients waiting no charge more than 62 days for first definitive treatment following a consultant’s decision to Commissioner for any corrective procedure or care Air embolism >0 upgrade the priority of the patient (all cancers) [Insert as per local determination] Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In 2% of revenue derived from the provision of the locally defined service line in the quarter of the under-achievement Quarterly A, CR Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual contract monthly value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Schedule 6 Part C in accordance with applicable Guidancethe Professional Letter £250 per day per patient affected Monthly A, recovery CR, S, C, MH Cancelled operations CB_B18 All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the cost patient’s choice Number of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients patients who are not offered another binding date within 28 days >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non- payment of costs associated with applicable Guidancecancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A, recovery CR, S, C, TP Mental health CB_B19 Care Programme Approach (CPA): The percentage of people under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Report [Insert as per local determination] [Insert as per local determination] MH, MHSS APPENDIX 4 Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: Summary of goals Goal Number Goal Name Description of Goal Goal weighting (% of CQUIN scheme available) Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) 1 Friends and Family Test To improve the cost experience of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-patients in line standard template on the website with Domain 4 of the NHS Institute Outcomes Framework. The Friends and Family Test will provide timely, granular feedback from patients about their experience. The 2011/12 national inpatient survey showed that only 13 per cent of patients in acute hospital inpatient wards and A&E departments were asked for Innovation and Improvement contains some additional fields to assist its automated functionsfeedback 2 NHS Safety Thermometer To reduce harm. Parties may include these additional fields in the completed version The power of the NHS Safety Thermometer lies in allowing frontline teams to measure how safe their services are and to deliver improvement locally 3 Dementia To incentivise the identification of patients with dementia and other causes of cognitive impairment alongside their other medical conditions, to prompt appropriate referral and follow up after they leave hospital and to ensure that hospitals deliver high quality care to people with dementia and support their carers. 4 VTE To reduce avoidable death, disability and chronic ill health from venous thromboembolism (VTE) 5 6 etc Totals: 100.00% CQUIN Table 2: Summary of indicators Goal Number Indicator Number Indicator Name Indicator Weighting (% of CQUIN scheme included available) Expected financial value of Indicator (£) 1 6 etc Totals: 100.00% CQUIN Table 3: Detail of indicator (to be completed for each indicator) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to Commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to Commissioner) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment Are there any rules for partial achievement of the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 indicator at the final indicator period/date? CQUIN Table 4: Milestones (BILATERAL)only to be completed for indicators that contain in-year milestones) Goal No. Indicator No. Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to Commissioner) Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Total: CQUIN Table 5: Rules for partial achievement at final indicator period/date (only complete if the indicator has rules for partial achievement at final indicator period/date) Goal No. Indicator No. Final indicator value for the part achievement threshold % of CQUIN scheme available for meeting final indicator value CQUIN Table 6: Maximum aggregate CQUIN Payment Contract Year Maximum aggregate CQUIN Payment 2013/14 2.5% of Actual Annual Value Subsequent years To be determined nationally and inserted locally CQUIN Table 7: CQUIN Payments on Account Commissioner Payment Frequency/Timing Agreed provisions for adjustment of Payments on CQUIN Account based on performance APPENDIX 5 Surveys Type of Survey Frequency Method of Reporting Method of Publication Friends and Family Test (where required in accordance with FFT Guidance) Service User Survey [Insert further description locally] Staff Surveys [Insert further description locally] Carer Survey [Insert further description locally] [Other insert locally]
Appears in 1 contract
Samples: www.england.nhs.uk
Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) …………………………………………………...Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) a Member, in the presence of: ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part Commissioner Requested Services and Essential Services Commissioner Requested Services Insert text locally or state Not Applicable Essential Services Insert text locally or state Not Applicable CRS Continuity Plan/Essential Services Continuity Plan Insert text locally or state Not Applicable APPENDIX 2 of Module B: Never Events Never Events National Quality Requirements National Quality Requirement Threshold (2013/14) Method of Measurement Never Event (2013/14) Consequence (per occurrence) Wrongly prepared high-risk injectable medication of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non-payment of inpatient episode Monthly A CB_A16 Rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report - Annual A CB_S6 Zero tolerance RTT waits over 52 weeks >0 Review of monthly Service Quality Performance Report £5,000 per patient waiting over 52 weeks Monthly A. C, MH where 18 weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes Handover >15 minutes Review of monthly Service Quality Performance Report £200 per patient waiting over 30 minutes Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes Handover > 15 minutes Review of monthly Service Quality Performance Report £1,000 per patient waiting over 60 minutes (in total, not aggregated with applicable CB_S7a consequence) Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call >15 minutes Review of monthly Service Quality Performance Report £20 per event where > 30 minutes Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call > 15 minutes Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) Monthly AM CB_S9 Trolley waits in A&E Any trolley wait > 12 hours Review of monthly Service Quality Performance Report £1,000 per breach Monthly A+E CB_S10 No urgent operation should be cancelled for a second time Number of urgent operations cancelled for a second time Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non-payment/ reimbursement of costs (as applicable) of rescheduled episode of care. Monthly A, CR, C, S Failure to publish Formulary Yes/No Publication on Provider’s website Withholding of up to 1% of the monthly sums payable by the Commissioners under Clause 7 (Prices and Payment) per month until publication Monthly All Duty of Candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance, recovery ) [Insert as per local determination] Recovery of the cost of the procedure episode of care or £10,000 if the cost of the episode of care is unknown. Monthly All Local Quality Requirements Quality Requirement Threshold Method of Measurement Consequence of breach Domain 1: Preventing people dying prematurely Insert text locally Domain 2: Enhancing the quality of life of people with long-term conditions Insert text locally Domain 3: Helping people to recover from episodes of ill-health or following injury Insert text locally Domain 4: Ensuring that people have a positive experience of care Insert text locally Domain 5: Treating and no charge caring for people in a safe environment and protecting them from avoidable harm Insert text locally All sums calculated in accordance with this Section 3 Part 1 of Module B will be subject to Commissioner an annual cap of 1.0% of Actual Annual Value APPENDIX 3 Operational Standards Ref Operational Standards Threshold (2013/14) Method of Measurement (2013/14) Consequence of breach Monthly or annual application of consequence Applicable Service Category RTT waiting times for any corrective procedure or care Maladministration non-urgent consultant-led treatment CB_B1 Percentage of potassium-containing solutions >0 admitted patients starting treatment within a maximum of 18 weeks from referral Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies CB_B2 Percentage of the cost non-admitted patients starting treatment within a maximum of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration 18 weeks from referral Operating standard of oral/enteral treatment >0 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies CB_B3 Percentage of the cost patients on incomplete non-emergency pathways (yet to start treatment) waiting no more than 18 weeks from referral Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 92% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance- Monthly A. C, recovery MH where 18 weeks applies Diagnostic test waiting times CB_B4 Percentage of the cost patients waiting less than 6 weeks from referral for a diagnostic test Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 99% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the month of the procedure and no charge to Commissioner for any corrective procedure under-achievement Monthly A, C A&E waits CB_B5 Percentage of A & E attendances where the patient was admitted, transferred or care Overdose discharged within 4 hours of midazolam during conscious sedation >0 their arrival at an A&E department Operating standard of 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A+E Cancer waits - 2 week wait CB_B6 Percentage of patients referred urgently with suspected cancer by a GP waiting no charge to Commissioner more than two weeks for any corrective procedure or care Opioid overdose first outpatient appointment Operating standard of an opioid-naïve Patient >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B7 Percentage of patients referred urgently with breast symptoms (where cancer was not initially suspected) waiting no charge to Commissioner more than two weeks for any corrective procedure or care Inappropriate administration first outpatient appointment Operating standard of daily oral methotrexate >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 31 days CB_B8 Percentage of patients waiting no charge more than one month (31 days) from diagnosis to Commissioner first definitive treatment for any corrective procedure or care Falls from unrestricted windows >0 all cancers Operating standard of 96% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B9 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Entrapment in bedrails >0 subsequent treatment where that treatment is surgery Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B10 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Transfusion subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of ABO-incompatible blood components >0 98% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B11 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 62 days CB_B12 Percentage of patients waiting no charge more than two months (62 days) from urgent GP referral to Commissioner first definitive treatment for any corrective procedure or care Wrong gas administered >0 cancer Operating standard of 85% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B13 Percentage of patients waiting no charge more than 62 days from referral from an NHS screening service to Commissioner first definitive treatment for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 all cancers Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B14 Percentage of patients waiting no charge more than 62 days for first definitive treatment following a consultant’s decision to Commissioner for any corrective procedure or care Air embolism >0 upgrade the priority of the patient (all cancers) [Insert as per local determination] Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In 2% of revenue derived from the provision of the locally defined service line in the quarter of the under-achievement Quarterly A, CR Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual contract monthly value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Schedule 6 Part C in accordance with applicable Guidancethe Professional Letter £250 per day per patient affected Monthly A, recovery CR, S, C, MH Cancelled operations CB_B18 All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the cost patient’s choice Number of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients patients who are not offered another binding date within 28 days >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non- payment of costs associated with applicable Guidancecancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A, recovery CR, S, C, TP Mental health CB_B19 Care Programme Approach (CPA): The percentage of people under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Report [Insert as per local determination] [Insert as per local determination] MH, MHSS APPENDIX 4 Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: Summary of goals Goal Number Goal Name Description of Goal Goal weighting (% of CQUIN scheme available) Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) 1 Friends and Family Test To improve the cost experience of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-patients in line standard template on the website with Domain 4 of the NHS Institute Outcomes Framework. The Friends and Family Test will provide timely, granular feedback from patients about their experience. The 2011/12 national inpatient survey showed that only 13 per cent of patients in acute hospital inpatient wards and A&E departments were asked for Innovation and Improvement contains some additional fields to assist its automated functionsfeedback 2 NHS Safety Thermometer To reduce harm. Parties may include these additional fields in the completed version The power of the NHS Safety Thermometer lies in allowing frontline teams to measure how safe their services are and to deliver improvement locally 3 Dementia To incentivise the identification of patients with dementia and other causes of cognitive impairment alongside their other medical conditions, to prompt appropriate referral and follow up after they leave hospital and to ensure that hospitals deliver high quality care to people with dementia and support their carers. 4 VTE To reduce avoidable death, disability and chronic ill health from venous thromboembolism (VTE) 5 6 etc Totals: 100.00% CQUIN Table 2: Summary of indicators Goal Number Indicator Number Indicator Name Indicator Weighting (% of CQUIN scheme included available) Expected financial value of Indicator (£) 1 6 etc Totals: 100.00% CQUIN Table 3: Detail of indicator (to be completed for each indicator) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to Commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to Commissioner) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment Are there any rules for partial achievement of the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 indicator at the final indicator period/date? CQUIN Table 4: Milestones (BILATERAL)only to be completed for indicators that contain in-year milestones) Goal No. Indicator No. Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to Commissioner) Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Total: CQUIN Table 5: Rules for partial achievement at final indicator period/date (only complete if the indicator has rules for partial achievement at final indicator period/date) Goal No. Indicator No. Final indicator value for the part achievement threshold % of CQUIN scheme available for meeting final indicator value CQUIN Table 6: Maximum aggregate CQUIN Payment Contract Year Maximum aggregate CQUIN Payment 2013/14 2.5% of Actual Annual Value Subsequent years To be determined nationally and inserted locally CQUIN Table 7: CQUIN Payments on Account Commissioner Payment Frequency/Timing Agreed provisions for adjustment of Payments on CQUIN Account based on performance APPENDIX 5 Surveys Type of Survey Frequency Method of Reporting Method of Publication Friends and Family Test (where required in accordance with FFT Guidance) Service User Survey [Insert further description locally] Staff Surveys [Insert further description locally] Carer Survey [Insert further description locally] [Other insert locally]
Appears in 1 contract
Samples: www.england.nhs.uk
Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) …………………………………………………...Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) a Member, in the presence of: ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part Commissioner Requested Services and Essential Services Commissioner Requested Services Insert text locally or state Not Applicable Essential Services Insert text locally or state Not Applicable CRS Continuity Plan/Essential Services Continuity Plan Insert text locally or state Not Applicable APPENDIX 2 of Module B: Never Events Never Events National Quality Requirements National Quality Requirement Threshold (2013/14) Method of Measurement Never Event (2013/14) Consequence (per occurrence) Wrongly prepared high-risk injectable medication of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non-payment of inpatient episode Monthly A CB_A16 Rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report Schedule 7 Part 1B Paragraph 4 Annual A CB_S6 Zero tolerance RTT waits over 52 weeks >0 Review of monthly Service Quality Performance Report £5,000 per patient waiting over 52 weeks Monthly A. C, MH where 18 weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes Handover >15 minutes Review of monthly Service Quality Performance Report £200 per patient waiting over 30 minutes Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes Handover > 15 minutes Review of monthly Service Quality Performance Report £1,000 per patient waiting over 60 minutes (in total, not aggregated with applicable CB_S7a consequence) Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call >15 minutes Review of monthly Service Quality Performance Report £20 per event where > 30 minutes Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call > 15 minutes Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) Monthly AM CB_S9 Trolley waits in A&E Any trolley wait > 12 hours Review of monthly Service Quality Performance Report £1,000 per breach Monthly A+E CB_S10 No urgent operation should be cancelled for a second time Number of urgent operations cancelled for a second time Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non-payment/ reimbursement of costs (as applicable) of rescheduled episode of care. Monthly A, CR, C, S Failure to publish Formulary Yes/No Publication on Provider’s website Withholding of up to 1% of the monthly sums payable by the Commissioners under Clause 7 (Prices and Payment) per month until publication Monthly All Duty of Candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance, recovery ) [Insert as per local determination] Recovery of the cost of the procedure episode of care or £10,000 if the cost of the episode of care is unknown. Monthly All Local Quality Requirements Quality Requirement Threshold Method of Measurement Consequence of breach Domain 1: Preventing people dying prematurely Insert text locally Domain 2: Enhancing the quality of life of people with long-term conditions Insert text locally Domain 3: Helping people to recover from episodes of ill-health or following injury Insert text locally Domain 4: Ensuring that people have a positive experience of care Insert text locally Domain 5: Treating and no charge caring for people in a safe environment and protecting them from avoidable harm Insert text locally All sums calculated in accordance with this Schedule 3 Part 1 will be subject to Commissioner an annual cap of 1.0% of Actual Annual Value APPENDIX 3 Operational Standards Ref Operational Standards Threshold (2013/14) Method of Measurement (2013/14) Consequence of breach Monthly or annual application of consequence Applicable Service Category RTT waiting times for any corrective procedure or care Maladministration non-urgent consultant-led treatment CB_B1 Percentage of potassium-containing solutions >0 admitted patients starting treatment within a maximum of 18 weeks from referral Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Schedule 7 Part 1B paragraph 1 Monthly A. C, recovery MH where 18 weeks applies CB_B2 Percentage of the cost non-admitted patients starting treatment within a maximum of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration 18 weeks from referral Operating standard of oral/enteral treatment >0 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Schedule 7 Part 1B paragraph 1 Monthly A. C, recovery MH where 18 weeks applies CB_B3 Percentage of the cost patients on incomplete non-emergency pathways (yet to start treatment) waiting no more than 18 weeks from referral Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 92% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Schedule 7 Part 1B paragraph1 Monthly A. C, recovery MH where 18 weeks applies Diagnostic test waiting times CB_B4 Percentage of the cost patients waiting less than 6 weeks from referral for a diagnostic test Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 99% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the month of the procedure and no charge to Commissioner for any corrective procedure under-achievement Monthly A, C A&E waits CB_B5 Percentage of A & E attendances where the patient was admitted, transferred or care Overdose discharged within 4 hours of midazolam during conscious sedation >0 their arrival at an A&E department Operating standard of 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A+E Cancer waits - 2 week wait CB_B6 Percentage of patients referred urgently with suspected cancer by a GP waiting no charge to Commissioner more than two weeks for any corrective procedure or care Opioid overdose first outpatient appointment Operating standard of an opioid-naïve Patient >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B7 Percentage of patients referred urgently with breast symptoms (where cancer was not initially suspected) waiting no charge to Commissioner more than two weeks for any corrective procedure or care Inappropriate administration first outpatient appointment Operating standard of daily oral methotrexate >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 31 days CB_B8 Percentage of patients waiting no charge more than one month (31 days) from diagnosis to Commissioner first definitive treatment for any corrective procedure or care Falls from unrestricted windows >0 all cancers Operating standard of 96% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B9 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Entrapment in bedrails >0 subsequent treatment where that treatment is surgery Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B10 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Transfusion subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of ABO-incompatible blood components >0 98% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B11 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 62 days CB_B12 Percentage of patients waiting no charge more than two months (62 days) from urgent GP referral to Commissioner first definitive treatment for any corrective procedure or care Wrong gas administered >0 cancer Operating standard of 85% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B13 Percentage of patients waiting no charge more than 62 days from referral from an NHS screening service to Commissioner first definitive treatment for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 all cancers Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B14 Percentage of patients waiting no charge more than 62 days for first definitive treatment following a consultant’s decision to Commissioner for any corrective procedure or care Air embolism >0 upgrade the priority of the patient (all cancers) [Insert as per local determination] Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In 2% of revenue derived from the provision of the locally defined service line in the quarter of the under-achievement Quarterly A, CR Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual contract monthly value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Schedule 6 Part C in accordance with applicable Guidancethe Professional Letter £250 per day per patient affected Monthly A, recovery CR, S, C, MH Cancelled operations CB_B18 All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the cost patient’s choice Number of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients patients who are not offered another binding date within 28 days >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non- payment of costs associated with applicable Guidancecancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A, recovery CR, S, C, TP Mental health CB_B19 Care Programme Approach (CPA): The percentage of people under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Report [Insert as per local determination] [Insert as per local determination] MH, MHSS APPENDIX 4 Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: Summary of goals Goal Number Goal Name Description of Goal Goal weighting (% of CQUIN scheme available) Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) 1 Friends and Family Test To improve the cost experience of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-patients in line standard template on the website with Domain 4 of the NHS Institute Outcomes Framework. The Friends and Family Test will provide timely, granular feedback from patients about their experience. The 2011/12 national inpatient survey showed that only 13 per cent of patients in acute hospital inpatient wards and A&E departments were asked for Innovation and Improvement contains some additional fields to assist its automated functionsfeedback 2 NHS Safety Thermometer To reduce harm. Parties may include these additional fields in the completed version The power of the NHS Safety Thermometer lies in allowing frontline teams to measure how safe their services are and to deliver improvement locally 3 Dementia To incentivise the identification of patients with dementia and other causes of cognitive impairment alongside their other medical conditions, to prompt appropriate referral and follow up after they leave hospital and to ensure that hospitals deliver high quality care to people with dementia and support their carers. 4 VTE To reduce avoidable death, disability and chronic ill health from venous thromboembolism (VTE) 5 6 etc Totals: 100.00% CQUIN Table 2: Summary of indicators Goal Number Indicator Number Indicator Name Indicator Weighting (% of CQUIN scheme included available) Expected financial value of Indicator (£) 1 6 etc Totals: 100.00% CQUIN Table 3: Detail of indicator (to be completed for each indicator) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to Commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to Commissioner) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment Are there any rules for partial achievement of the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 indicator at the final indicator period/date? CQUIN Table 4: Milestones (BILATERAL)only to be completed for indicators that contain in-year milestones) Goal No. Indicator No. Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to Commissioner) Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Total: CQUIN Table 5: Rules for partial achievement at final indicator period/date (only complete if the indicator has rules for partial achievement at final indicator period/date) Goal No. Indicator No. Final indicator value for the part achievement threshold % of CQUIN scheme available for meeting final indicator value CQUIN Table 6: Maximum aggregate CQUIN Payment Contract Year Maximum aggregate CQUIN Payment 2013/14 2.5% of Actual Annual Value Subsequent years To be determined nationally and inserted locally CQUIN Table 7: CQUIN Payments on Account Commissioner Payment Frequency/Timing Agreed provisions for adjustment of Payments on CQUIN Account based on performance APPENDIX 5 Surveys Type of Survey Frequency Method of Reporting Method of Publication Friends and Family Test (where required in accordance with FFT Guidance) Service User Survey [Insert further description locally] Staff Surveys [Insert further description locally] Carer Survey [Insert further description locally] [Other insert locally]
Appears in 1 contract
Samples: www.england.nhs.uk
Signature of Authorised signatory. Signature of Authorised signatory OR WHERE PROVIDER IS AN INCORPORATED COMPANY Executed as a deed by the Provider ) acting by [insert name of Director], ) …………………………………………………... a director, in the presence of: ) …………………………………………………...Director Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… OR WHERE PROVIDER IS A LIMITED LIABILITY PARTNERSHIP Executed as a deed by the Provider ) acting by [insert name of Member], ) Member member and [insert name of ) Member], Member ) …………………………………………………... Signature of Member …………………………………………………... Signature of Member OR Executed as a deed by the Provider ) acting by [insert name of Member], ) a Member, in the presence of: ) …………………………………………………... a Member, in the presence of: ) Member Witness Signature: ……………………………………… Name: ……………………………………… Address: ……………………………………… Occupation: ……………………………………… APPENDIX 1 Section 3 Part Commissioner Requested Services and Essential Services Commissioner Requested Services Insert text locally or state Not Applicable Essential Services Insert text locally or state Not Applicable CRS Continuity Plan/Essential Services Continuity Plan Insert text locally or state Not Applicable APPENDIX 2 of Module B: Never Events Never Events National Quality Requirements National Quality Requirement Threshold (2013/14) Method of Measurement Never Event (2013/14) Consequence (per occurrence) Wrongly prepared high-risk injectable medication of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non-payment of inpatient episode Monthly A CB_A16 Rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report As set out in Paragraph 2 of Module E Annual A CB_S6 Zero tolerance RTT waits over 52 weeks >0 Review of monthly Service Quality Performance Report £5,000 per patient waiting over 52 weeks Monthly A. C, MH where 18 weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes Handover >15 minutes Review of monthly Service Quality Performance Report £200 per patient waiting over 30 minutes Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes Handover > 15 minutes Review of monthly Service Quality Performance Report £1,000 per patient waiting over 60 minutes (in total, not aggregated with applicable CB_S7a consequence) Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call >15 minutes Review of monthly Service Quality Performance Report £20 per event where > 30 minutes Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes Crew ready to accept new call > 15 minutes Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) Monthly AM CB_S9 Trolley waits in A&E Any trolley wait > 12 hours Review of monthly Service Quality Performance Report £1,000 per breach Monthly A+E CB_S10 No urgent operation should be cancelled for a second time Number of urgent operations cancelled for a second time Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non-payment/ reimbursement of costs (as applicable) of rescheduled episode of care. Monthly A, CR, C, S Failure to publish Formulary Yes/No Publication on Provider’s website Withholding of up to 1% of the monthly sums payable by the Commissioners under Clause 7 (Prices and Payment) per month until publication Monthly All Duty of Candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance, recovery ) [Insert as per local determination] Recovery of the cost of the procedure episode of care or £10,000 if the cost of the episode of care is unknown. Monthly All Local Quality Requirements Quality Requirement Threshold Method of Measurement Consequence of breach Domain 1: Preventing people dying prematurely Insert text locally Domain 2: Enhancing the quality of life of people with long-term conditions Insert text locally Domain 3: Helping people to recover from episodes of ill-health or following injury Insert text locally Domain 4: Ensuring that people have a positive experience of care Insert text locally Domain 5: Treating and no charge caring for people in a safe environment and protecting them from avoidable harm Insert text locally All sums calculated in accordance with this Schedule 16 Part 1 of Module D will be subject to Commissioner an annual cap of 1.0% of Actual Annual Value APPENDIX 3 Operational Standards Ref Operational Standards Threshold (2013/14) Method of Measurement (2013/14) Consequence of breach Monthly or annual application of consequence Applicable Service Category RTT waiting times for any corrective procedure or care Maladministration non-urgent consultant-led treatment CB_B1 Percentage of potassium-containing solutions >0 admitted patients starting treatment within a maximum of 18 weeks from referral Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Paragraph 1 of Module E Monthly A. C, recovery MH where 18 weeks applies CB_B2 Percentage of the cost non-admitted patients starting treatment within a maximum of the procedure and no charge to Commissioner for any corrective procedure or care Wrong route administration 18 weeks from referral Operating standard of oral/enteral treatment >0 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Paragraph 1 of Module E Monthly A. C, recovery MH where 18 weeks applies CB_B3 Percentage of the cost patients on incomplete non-emergency pathways (yet to start treatment) waiting no more than 18 weeks from referral Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Intravenous administration of epidural medication >0 92% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable GuidanceAs set out in Paragraph 1 of Module E Monthly A. C, recovery MH where 18 weeks applies Diagnostic test waiting times CB_B4 Percentage of the cost patients waiting less than 6 weeks from referral for a diagnostic test Operating standard of the procedure and no charge to Commissioner for any corrective procedure or care Maladministration of Insulin >0 99% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the month of the procedure and no charge to Commissioner for any corrective procedure under-achievement Monthly A, C A&E waits CB_B5 Percentage of A & E attendances where the patient was admitted, transferred or care Overdose discharged within 4 hours of midazolam during conscious sedation >0 their arrival at an A&E department Operating standard of 95% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A+E Cancer waits - 2 week wait CB_B6 Percentage of patients referred urgently with suspected cancer by a GP waiting no charge to Commissioner more than two weeks for any corrective procedure or care Opioid overdose first outpatient appointment Operating standard of an opioid-naïve Patient >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B7 Percentage of patients referred urgently with breast symptoms (where cancer was not initially suspected) waiting no charge to Commissioner more than two weeks for any corrective procedure or care Inappropriate administration first outpatient appointment Operating standard of daily oral methotrexate >0 93% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 31 days CB_B8 Percentage of patients waiting no charge more than one month (31 days) from diagnosis to Commissioner first definitive treatment for any corrective procedure or care Falls from unrestricted windows >0 all cancers Operating standard of 96% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B9 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Entrapment in bedrails >0 subsequent treatment where that treatment is surgery Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B10 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Transfusion subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of ABO-incompatible blood components >0 98% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B11 Percentage of patients waiting no charge to Commissioner more than 31 days for any corrective procedure or care Misplaced naso- or oro-gastric tubes >0 subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR Cancer waits - 62 days CB_B12 Percentage of patients waiting no charge more than two months (62 days) from urgent GP referral to Commissioner first definitive treatment for any corrective procedure or care Wrong gas administered >0 cancer Operating standard of 85% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B13 Percentage of patients waiting no charge more than 62 days from referral from an NHS screening service to Commissioner first definitive treatment for any corrective procedure or xxxx Xxxxxxx to monitor and respond to oxygen saturation >0 all cancers Operating standard of 90% Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance with applicable Guidance, recovery 2% of revenue derived from the provision of the cost locally defined service line in the quarter of the procedure and under-achievement Quarterly A, CR CB_B14 Percentage of patients waiting no charge more than 62 days for first definitive treatment following a consultant’s decision to Commissioner for any corrective procedure or care Air embolism >0 upgrade the priority of the patient (all cancers) [Insert as per local determination] Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In 2% of revenue derived from the provision of the locally defined service line in the quarter of the under-achievement Quarterly A, CR Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual monthly contract value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of actual contract monthly value with an end of year reconciliation with 2% of the Actual Outturn Value of the Agreement retained if annual performance is not met or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Schedule 6 Part C in accordance with applicable Guidancethe Professional Letter £250 per day per patient affected Monthly A, recovery CR, S, C, MH Cancelled operations CB_B18 All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the cost patient’s choice Number of the procedure and no charge to Commissioner for any corrective procedure or care Severe scalding of Patients patients who are not offered another binding date within 28 days >0 Review of reports submitted to National Patient Safety Agency (or successor body)/Serious Incidents reports and monthly Service Quality Performance Report In accordance Non- payment of costs associated with applicable Guidancecancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A, recovery CR, S, C, TP Mental health CB_B19 Care Programme Approach (CPA): The percentage of people under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Report [Insert as per local determination] [Insert as per local determination] MH, MHSS APPENDIX 4 Commissioning for Quality and Innovation (CQUIN) CQUIN Table 1: Summary of goals Goal Number Goal Name Description of Goal Goal weighting (% of CQUIN scheme available) Expected financial value of Goal (£) Quality Domain (Safety, Effectiveness, Patient Experience or Innovation) 1 Friends and Family Test To improve the cost experience of the procedure and no charge to Commissioner for any corrective procedure or care 1 The on-patients in line standard template on the website with Domain 4 of the NHS Institute Outcomes Framework. The Friends and Family Test will provide timely, granular feedback from patients about their experience. The 2011/12 national inpatient survey showed that only 13 per cent of patients in acute hospital inpatient wards and A&E departments were asked for Innovation and Improvement contains some additional fields to assist its automated functionsfeedback 2 NHS Safety Thermometer To reduce harm. Parties may include these additional fields in the completed version The power of the NHS Safety Thermometer lies in allowing frontline teams to measure how safe their services are and to deliver improvement locally 3 Dementia To incentivise the identification of patients with dementia and other causes of cognitive impairment alongside their other medical conditions, to prompt appropriate referral and follow up after they leave hospital and to ensure that hospitals deliver high quality care to people with dementia and support their carers. 4 VTE To reduce avoidable death, disability and chronic ill health from venous thromboembolism (VTE) 5 6 etc Totals: 100.00% CQUIN Table 2: Summary of indicators Goal Number Indicator Number Indicator Name Indicator Weighting (% of CQUIN scheme included available) Expected financial value of Indicator (£) 1 6 etc Totals: 100.00% CQUIN Table 3: Detail of indicator (to be completed for each indicator) Indicator number Indicator name Indicator weighting (% of CQUIN scheme available) Description of indicator Numerator Denominator Rationale for inclusion Data source Frequency of data collection Organisation responsible for data collection Frequency of reporting to Commissioner Baseline period/date Baseline value Final indicator period/date (on which payment is based) Final indicator value (payment threshold) Rules for calculation of payment due at final indicator period/date (including evidence to be supplied to Commissioner) Final indicator reporting date Are there rules for any agreed in-year milestones that result in payment Are there any rules for partial achievement of the contract NATIONAL VARIATION DEED 2012/13 – FOR STANDARD CARE HOME SERVICES CONTRACT 2011/2012 indicator at the final indicator period/date? CQUIN Table 4: Milestones (BILATERAL)only to be completed for indicators that contain in-year milestones) Goal No. Indicator No. Date/period milestone relates to Rules for achievement of milestones (including evidence to be supplied to Commissioner) Date milestone to be reported Milestone weighting (% of CQUIN scheme available) Total: CQUIN Table 5: Rules for partial achievement at final indicator period/date (only complete if the indicator has rules for partial achievement at final indicator period/date) Goal No. Indicator No. Final indicator value for the part achievement threshold % of CQUIN scheme available for meeting final indicator value CQUIN Table 6: Maximum aggregate CQUIN Payment Contract Year Maximum aggregate CQUIN Payment 2013/14 2.5% of Actual Annual Value Subsequent years To be determined nationally and inserted locally CQUIN Table 7: CQUIN Payments on Account Commissioner Payment Frequency/Timing Agreed provisions for adjustment of Payments on CQUIN Account based on performance APPENDIX 5 Surveys Type of Survey Frequency Method of Reporting Method of Publication Friends and Family Test (where required in accordance with FFT Guidance) Service User Survey [Insert further description locally] Staff Surveys [Insert further description locally] Carer Survey [Insert further description locally] [Other insert locally]
Appears in 1 contract
Samples: www.england.nhs.uk
