Thursday, 14 January 2010


CQUIN payments could put AKI on the acute trust map. Commissioning for Quality and Innovation, CQUINs, were introduced as part of the quality framework in the wake of the vision set out in “High Quality Care for All”. The framework was launched in April 2009 to strengthen quality as the organising principle of the NHS. In the first year 0.5% of overall Trust income came in the form of CQUIN payments.

In some Strategic Health Authority areas commissioners agreed with Trusts that the extent of the mandated National Renal Dataset completion would be part of the scheme. I haven’t heard specifically about the impact of the NRDS inclusion yet, and of course the year 2009/10 still has a quarter to run, but overall CQUINs seem to have been well received.

So this coming year from 2010/11 1.5% of Acute Trust income will be conditional on meeting the CQUIN goals. Venous thromboembolism has been chosen as a national CQUIN and the Department of Health has also developed exemplars in other areas including AKI. The AKI CQUIN identifies a basket of measures aimed at improving the prevention, detection and management of cases of AKI in patients admitted to hospital through appropriate screening and monitoring checks. These include a risk assessment for AKI at initial clerking, check and recheck of serum creatinine within 24 hours, urinalysis, senior review within 12 hours and care planning to spot deterioration and manage appropriately. It is suggested that this should apply to all emergency admissions with ratcheted payments to the Trust dependent on achieving the targets. Such that 70% compliance would attract 50% of the allocated payment, 80% compliance – 70% payment and 90% - 90%.

These CQUINS need to be negotiated locally.

Full link from which AKI CQUIN is taken (NHS Inst for Innovation & Improvement):
Commissioning for Quality and Innovation (CQUIN) payment framework
Dept of Health publications & policy : CQUIN