CQUIN at NUH
Read about how the team at Nottingham University Hospitals NHS Trust made best use of NPT right across the Trust here...
The CQUIN payment framework enables commissioners to reward excellence, by linking a proportion of healthcare providers' income to the achievement of local quality improvement goals. Since the first year of the CQUIN framework (2009/10), many CQUIN schemes have been developed and agreed. Often CQUIN has three levels, national goals, regional goals and local goals. Regional and local goals are agreed in discussion with commissioners and providers.
Nottingham Trust had a CQUIN target associated solely with patient experience measurement and improvement. Alongside this the Trust also has a legal compliance and duty of care associated with patient experience management, along with legal requirements in fulfilling the Equality Act 2010.
Overall the aim was the implementation of a single consolidated patient experience survey tool, to provide a comprehensive real-time capture, reporting and alerting mechanism for the Trust. To consolidate all of the existing manual and electronic surveys that are currently undertaken across the Trust and provide a strategic platform for all future patient (and potentially staff) surveys.
The aims of the CQUIN were to
• Survey 10% of inpatients on day of discharge asking the net promoter question from April 1st 2012.
• Survey 50 patients per directorate on the 5 patient experience CQUIN questions.
• Establish a system to report the above results at ward, specialty and directorate level to board, commissioners and patients and public on a monthly/weekly/daily basis.
• Monitor performance and make a 10 point improvement on the net promoter score using Month 1 of financial year 2012/13.
• Achieve CQUIN targets.
• Improve patient experience.
The survey was piloted in 2 areas 2 weeks prior to rollout; this was done to test questions as well as gaining staff support and feedback. Challenges were faced in relation to the length of the survey and gaining feedback from staff.
Improvement for patients were the availability of surveys in different formats to meet individual patient needs eg large print, audio, cartoon. Staff improvements were also seen in relation to the availability of data and increase in ability to do analysis and the reduction in duplication which releases staff time.
In enabling real-time capture and reporting of patient experience, staff and managers have the ability to act immediately to address any highlighted shortfalls in patient experience in line with a ‘You said, we did’ approach.
Similarly, as change initiatives are undertaken across the Trust, the system could provide the capability for detailed baseline and re-measurement of the impacts on patient experience, again in real-time.