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Enhanced Recovery CQUIN payments

2011 May 16
by webmaster

Over the last month we have had a number of discussions and enquiries about CQUIN payments and enhanced recovery, so we thought we would signpost the following links and sources of information that you may find useful.

In essence, the Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement goals. The original guidance was published in 2008 and introduced the CQUIN payment framework. It remains the key point of reference but there are more recently published national goals for 2011/12 which detail enhanced recovery payment schemes.

A good starting point is the NHS Institute website which gives a clear outline of CQUIN and good links to DOH documents without the need to search the DOH website – Click here to access

NHS London also have some good resources and examples and have included enhanced recovery in all of their CQUIN payment agreements with provider trusts – Click here to access an explanation of their approach and click here to go to their CQUIN homepage.

Click here for a link to the “Exemplar CQUIN goals” document – the enhanced recovery detail is on pages 41-43

We would like to know more about CQUIN payments for enhanced recovery across the country and would be grateful for your feedback and thoughts.

  • Is enhanced recovery part of your trust CQUIN payments?
  • What have you agreed locally as the indicators?
  • How are you collecting data to prove compliance and improvements to the indicators?
  • Do you have a specific enhanced recovery outcomes database?
  • If you have already implemented enhanced recovery how are you further reducing length of stay? or have you chosen other indicator of improvement?


One Response
  1. wendy lewis permalink
    May 16, 2011

    Wirral’s Commissioners and the 3 GP COnsortia have used the cquin payments to ensure ERP pathways for elective surgical patients on Wirral for 2011/12. They worked with a team that had already implemented in colorectal surgery and asked what support they could offer to promote spread to other specialities. The CQuIn contract has brought 4 new specialties to the table and we’re busy preparing for implementation across 10 elective pathways from Colorectal, gyane, urology, orhtopaedics and vascular teams.
    The indicators were agreed between the “central” Trust team, (newly established project manager, clinical ERP lead and ERP Project Board Chair), the commissioning manager and clinical leads. We’ve agreed that each pathway will be assessed against 5 common milestones that demonstrate implementation of ERP elements along the patient pathway from primary care to post discharge. Reduction in length of stay and readmissions and an improvement in patient experience will be measured from Q2 against an agreed baseline.
    We are using the National Reporting Tool to prove compliance with the elements because its ready made and easy! The colorectal team have been using their own excel spreadsheeet for 4 years now, they will continue to use this at their own choice due to their wish to maintain a database with 500+ patients recorded.Data collection is a significant undertaking for these new pathways, Commissioners have offered funds to the Trust as an enabler to achieve the cquin by funding a designated data collector for 12 months.
    For the established colorectal team we are using the CQUIN as an incentive to re-achieve and sustain our best LOS and readmission figures so there are quite specific targets for elective resection pathways and an additional pathway for inclusion in the proramme= reversal/ closure of stoma.

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