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The Clinical Commissioning Group Outcomes Indicator Set (CCGOIS) (formerly known as the 'Commissioning Outcomes Framework' [COF]) forms an integral part of NHS England’s approach to quality improvement in healthcare.

The aim of the CCGOIS is to support clinical commissioning groups (CCGs) to plan for health improvement by providing information for measuring and benchmarking outcomes of services commissioned by them. It also provides clear information for patients and the public about the quality of health services commissioned by CCGs and the associated health outcomes, and acts as a yardstick against which CCGs are judged for their contribution towards improving patient outcomes and the quality of commissioning.

The CCGOIS has been selected on the basis that all the indicators contribute to the five domains of the NHS Outcomes Framework (see below).

NHS Outcomes Framework 'five domains'
  • Domain 1–preventing people from dying prematurely
  • Domain 2–enhancing quality of life for people with long-term conditions
  • Domain 3–helping people to recover from episodes of ill health, or following injury
  • Domain 4–ensuring that people have a positive experience of care
  • Domain 5–treating and caring for people in a safe environment; and protecting them from avoidable harm.

NOTES & LEGEND

NHS OF: indicator derived from NHS Outcomes Framework
* NHS OF indicator that is also measurable at local authority level
NHS OF indicator shared with Public Health Outcomes Framework
NHS OF indicator complementary with Adult Social Care Outcomes Framework
Other indicators are developed from NICE quality standards or other existing data collections.


1: Preventing people from dying prematurely
OVERARCHING INDICATOR
  • Potential years of life lost from causes considered amenable to healthcare: adults, children and young people (NHS OF 1a i & ii) *
IMPROVEMENT AREAS
Reducing premature mortality from the major causes of death
  • Under 75 mortality from cardiovascular disease (NHS OF 1.1) *
  • Cardiac rehabilitation completion
  • Myocardial infarction, stroke, and stage 5 kidney disease in people with diabetes
  • Mortality within 30 days of hospital admission for stroke
  • Under 75 mortality from respiratory disease (NHS OF 1.2) *
  • Under 75 mortality from liver disease (NHS OF 1.3) *
  • Emergency admissions for alcohol-related liver disease
  • Under 75 mortality from cancer (NHS OF 1.4) *
  • One year survival from all cancers (NHS OF 1.4.i) *
  • One year survival from breast, lung, and colorectal cancers (NHS OF 1.4 iii) *
  • Cancer: diagnosis via emergency routes
  • Cancer: record of stage at diagnosis
  • Cancer: early detection
  • Lung cancer: record of stage at diagnosis
  • Breast cancer: mortality
  • Heart failure: 12 month all cause mortality
  • Hip fracture: incidence
Reducing premature death in people with serious mental illness
  • People with severe mental illness who have received a list of physical checks
  • Severe mental illness: smoking rates
Reducing deaths in babies and young children
  • Antenatal assessment <13 weeks
  • Maternal smoking at delivery
  • Breastfeeding prevalence at 6–8 weeks
Reducing premature deaths in people with learning disabilities
NHS OF indicator in development. No CCG measure at present
2: Enhancing quality of life for people with long-term conditions
OVERARCHING INDICATOR
  • Health-related quality of life for people with long-term conditions (NHS OF 2) *
IMPROVEMENT AREAS
Ensuring people feel supported to manage their condition
  • People feeling supported to manage their condition (NHS OF 2.1) *
Improving functional ability in people with long-term conditions
  • People with COPD and Medical Research Council Dyspnoea scale ≤3 referred to a pulmonary rehabilitation programme
  • People with diabetes who have received nine care processes
  • People with diabetes diagnosed less than 1 year referred to structured education
Reducing time spent in hospital by people with long-term conditions
  • Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) (NHS OF 2.3.i) *
  • Unplanned hospitalisation for asthma, diabetes, and epilepsy in under 19s (NHS OF 2.3.ii) *
  • Complications associated with diabetes including emergency admission for diabetic ketoacidosis and lower limb amputation
>Enhancing quality of life for carers
  • Health-related quality of life for carers (NHS OF 1.4)
Enhancing quality of life for people with mental illness
  • Access to community mental health services by people from BME groups
  • Access to psychological therapy services by people from BME groups
  • Recovery following talking therapies (all ages and older than 65)
  • Health-related quality of life for people with a long-term mental health condition
Enhancing quality of life for people with dementia
  • Estimated diagnosis rate for people with dementia (NHS OF measure in development. No CCG measure at present)
  • People with dementia prescribed anti-psychotic medication
3: Helping people to recover from episodes of ill health or following injury
OVERARCHING INDICATOR
  • Emergency admissions for acute conditions that should not usually require hospital admission (NHS OF 3a) *
  • Emergency readmissions within 30 days of discharge from hospital (NHS OF 3b)
IMPROVEMENT AREAS
Improving outcomes from planned treatments
  • Increased health gain as assessed by patients for elective procedures:
    1. hip replacement
    2. knee replacement
    3. groin hernia
    4. varicose veins (NHS OF 3.1 i–iv)
Preventing lower respiratory tract infections in children from becoming serious
  • Emergency admissions for children with lower respiratory tract infections (NHS OF 3.2)*
Improving recovery from injuries and trauma
NHS OF indicator in development. No CCG measure at present
Improving recovery from stroke
  • People who have had a stroke who
    • are admitted to an acute stroke unit within 4 hours of arrival to hospital
    • receive thrombolysis following an acute stroke
    • are discharged from hospital with a joint health and social care plan
    • receive a follow-up assessment between 4–8 months after initial admission
    • spend 90% or more of their stay on an acute stroke unit
Improving recovery from fragility fractures
  • Proportion of patients recovering to their previous level of mobility or walking ability (NHS OF 3.5 i and ii)
  • Hip fracture: formal hip fracture programme, timely surgery, and multifactorial risk assessment
Helping older people to recover their independence after illness or injury
No CCG measure at present
Improving recovery from mental illness
  • Alcohol admissions and readmissions
  • Mental health readmissions within 30 days of discharge
  • Proportion of adults in contact with secondary mental health services in paid employment
4: Ensuring that people have a positive experience of care
OVERARCHING INDICATOR
Patient experience of primary and hospital care
  • Patient experience of GP out of hours services (NHS OF 4a ii) *
  • Patient experience of hospital care (NHS OF 4b)
  • Friends and family test for acute inpatient care and A&E (NHS OF 4c)
IMPROVEMENT AREAS
Improving people’s experience of outpatient care
  • Patient experience of outpatient services (NHS OF 4.1)
Improving hospitals’ responsiveness to personal needs
  • Responsiveness to in-patients’ personal needs (NHS OF 4.2)
Improving people’s experience of accident and emergency services
  • Patient experience of A&E services (NHS OF 4.3)
Improving women and their families’ experience of maternity services
Improving the experience of care for people at the end of their lives
  • Bereaved carers’ views on the quality of care in the last 3 months of life (NHS OF 4.6)
Improving experience of healthcare for people with mental illness
  • Patient experience of community mental health services (NHS OF 4.7)
Improving children and young people’s experience of healthcare
NHS OF indicator in development. No CCG measure at present
Improving people’s experience of integrated care
NHS OF indicator in development. No CCG measure at present
5: Treating and caring for people in a safe environment and protecting them from avoidable harm
OVERARCHING INDICATOR
  • Patient safety incidents reported (NHS OF 5a)
IMPROVEMENT AREAS
Reducing the incidence of avoidable harm
  • Incidence of healthcare associated infection: MRSA (NHS OF 5.2.i)
  • Incidence of healthcare associated infection: C. difficile (NHS OF 5.2.ii)
No CCG measures at present for category 2, 3, and 4 pressure ulcers and incidence of medication errors causing serious harm
Improving the safety of maternity services
No CCG measure at present
Delivering safe care to children in acute settings
No CCG measure at present