Monday, 20 December 2010

NHS Outcome Framework: highlights CKD but misses AKI

The NHS Outcomes Framework was published today (20 December 2010) and follows the format consulted on in July. Its aims are:

  • To provide a national level overview of how well the NHS is performing wherever possible in an international context;

  • To provide an accountability mechanism between the Secretary of State for Health and the NHS Commissioning Board;

  • To act as a catalyst for driving quality improvement and outcome measurement throughout the NHS by measuring a change in culture and behaviour, including a renewed focus on tackling inequalities in outcomes.

The level of ambition and the pace of expected improvement have not been sent for 2011/12 but although the targets have not yet been set and further work is needed on the majority of indicators have no fear, this will define the future direction of the NHS over the next few years. Integration across the separate public health outcomes framework and the adult social care outcomes framework will be required to deliver the NHS outcomes that matter to the public.

Chronic kidney disease is specifically mentioned in domains 1 and 2 – preventing people dying prematurely and enhancing the quality of life for people living with long term conditions and the graphic above explains how the outcome domains relate to the NICE quality standards, commissioning and payments.

Recovering from ill health, patients experience of care and safety are also highly relevant to CKD and AKI and of course, failure to mention them explicitly doesn’t mean that they are excluded. Indeed, safe prescribing, urgent and emergency care, end of life care, MRSA and urinary tract infection all figure prominently and all are relevant to kidney care.