Recommendation 144

Metrics for commissioners on quality

The NHS Commissioning Board should ensure the development of metrics on quality and outcomes of care for use by commissioners in managing the performance of providers, and retain oversight of these through its regional offices, if appropriate.

The NHS Outcomes Framework 2013/14 contains a range of indicators that provide a balanced coverage of NHS activity that, taken together, provide a national overview of how well the NHS is performing.  They provide the accountability mechanism between the Secretary of State for Health and NHS England for the effective spending of public money.  The indicators are set out in five domains that cover the preventing of premature mortality; enhancing quality of life for people with long term conditions; helping people recover from episodes of ill health; ensuring the people have a positive experience of care; and treating people in safe environments and protecting them from avoidable harm.

In addition to this, NHS England also publishes a range of data that supports improvement.  In June 2013, NHS England published the first two specialities level data, cardiac surgery and vascular, and announced the publication schedule for a further eight specialties.  All specialties have since been published.

NHS England will widen this programme to include other specialties over time and the data published will, initially, be refreshed annually.  This data will continue to be published as part of NHS Choices website.


The Clinical Commissioning Group Outcomes Indicator Set provides clear, comparative information for Clinical Commissioning Groups, Health and Wellbeing Boards, local authorities and patients and the public about the quality of health services commissioned by Clinical Commissioning Groups and the associated health outcomes. They are useful for Clinical Commissioning Groups and Health and Wellbeing Boards in identifying local priorities for quality improvement and to demonstrate progress that local health systems are making on outcomes. The measures are developed from NHS Outcomes Framework indicators that can be measured at Clinical Commissioning Group level together with additional indicators developed by the National Institute for Health and Care Excellence and the Health and Social Care Information Centre. Additional measures are added annually

NHS England plans to publish consultant-level outcomes data from all appropriate NHS funded national clinical audits before 2020.   The Consultant Outcomes Publication began with ten national clinical audits in June 2013. Consultant data for neurosurgery and upper gastro-intestinal has also now been published.  NHS England will improve the way in which data is published and has supported the development of patient-friendly guidance which has been issued to professional societies. This outlines the indicators that must be included in consultant level reporting such as patient involvement in publication and the linking of results for the department to an individual’s work at the trusts they practice in.