Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

38 2. 2012/13 Quality Schemes
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
2012/13 Quality Schemes
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. There are four
nationally mandated CQUIN goals
(items 1-4) and a number of locally
agreed goals.
A summary of these CQUIN’s is set out
below. Currently the Trust is on track to
achieve all of the agreed measures apart
from the Dementia CQUIN which was
subject to in-year change (see *below).
1. Venous Thromboembolism
(VTE) Risk Assessment
The percentage of eligible patients
who were assessed for risk of
developing a venous
thromboembolism (blood clot).
2012/13 Target – 90%
2012/13 Achieved – 94.6%
2. Patient Experience
This indicator draws together
the response of patients to
five questions identified by the
Department of Health that were
in the 2012 National Inpatient
Survey. The responses form an
index-based score. The Trust’s
score of 73.3 compares favourably
with national benchmarks and
is an increase on last year’s
achievement.
2012/13 Target – 73.5%
2012/13 Achieved – 73.3%
3. Dementia Screening
This indicator represents the
Trust’s progress in meeting new
national guidelines in relation
to the early recognition of
undiagnosed dementia. This
indicator requires that the Trust
identifies patients who may be
exhibiting symptoms of dementia,
assesses them and refers them on
to appropriate care.
3a. Dementia Case Finding
The percentage of all patients
aged 75 and above, admitted as
emergency inpatients, who are
asked the dementia case finding
question within 72 hours of
admission, or who have a clinical
diagnosis of delirium on initial
assessment or known diagnosis
of dementia.
2012/13 Target – 90%
2012/13 – please see update
below*
3b. Dementia Diagnostic
Assessment and Investigation
The percentage of all patients
aged 75 and above, admitted
as emergency inpatients, who
have scored positively on the
case finding question, or who
have a clinical diagnosis of
delirium reported as having had a
dementia diagnostic assessment
including investigations.
2012/13 Target – 90%
2012/13 please see update below*
3c. Referral for Specialist
Diagnosis
The percentage of all patients
aged 75 and above, admitted
as emergency inpatients, who
have had a diagnostic assessment
(in whom the outcome is either
'positive' or 'inconclusive' who
are referred for further diagnostic
advice or follow up.
2012/13 Target – 90%
2012/13 – please see update
below*
* A developmental Dementia CQUIN was
agreed with Devon PCT in April 2012. In
May 2012 national guidance was published
which indicated payment was only available
following the successful achievement of
90% compliance with all three elements of
the CQUIN across all eligible patients. Devon
PCT informed us that this would constitute
a change to the CQUIN. Subsequently it has
become apparent that not all commissioners
have applied this guidance and are recognizing
the complexity of the development work that
this CQUIN entails. The commissioners have
agreed a partial payment in recognition of
the significant quality, cultural and systemic
improvements that have been achieved for
patients and carers living with dementia. The
Commissioners have recognized this as partial
achievement of the CQUIN target.
4. Patient Safety Thermometer
The Safety Thermometer is a
nationally designed tool which
monitors four types of potential
harm:
• Venous thromboembolism
(blood clot)
• Patient falls
• Pressure ulcers