.

Liberating the NHS:

Transparency in outcomes
- a framework for the

NHS

Your response to the consultation questions

Your details	
Name *	     	
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Organisation type: e.g. individual, Trust, patient organisation etc	     	
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CHAPTER 2: Scope, purpose and principles of an NHS Outcomes Framework	
Principles	
1.	Do you agree with the key principles which will underpin the development of the NHS Outcomes Framework (page 10)?
	     	
2.	Are there any other principles which should be considered?

	     
	
3.	How can we ensure that the NHS Outcomes Framework will deliver more equitable outcomes and contribute to a reduction in health inequalities?
	     	
4.	How can we ensure that where outcomes require integrated care across the NHS, public health and/or social care services, this happens?
	     	
Five Domains	
5.	Do you agree with the five domains that are proposed in figure 1 (page 14) as making up the NHS Outcomes Framework?
	     	
6.	Do they appropriately cover the range of healthcare outcomes that the NHS is responsible for delivering to patients?	     	
Structure		
7.	Does the proposed structure of the NHS Outcomes Framework under each domain seem sensible?  	     	

CHAPTER 3: What would an NHS Outcomes Framework look like?	
Domain 1 – Preventing people from dying prematurely	
8.	Is ‘mortality amenable to healthcare’ an appropriate overarching outcome indicator to use for this domain? Are there any others that should be considered?
	     	
9.	Do you think the method proposed at para 3.7-3.9 (page 20) is an appropriate way to select improvement areas in this domain?
	     	
10.	Does the NHS Outcomes Framework take sufficient account of avoidable mortality in older people as proposed in para 3.11 (page 21)?	     	
11.	If not, what would be a suitable outcome indicator to address this issue? 	     	
12.	Are either of the suggestions at para 3.13 (page 21) appropriate areas of focus for mortality in children? Should anything else be considered?	     	
Domain 2 – Enhancing the quality of life for people with long-term conditions	
13.	Are either of the suggestions at para 3.19 (page 24) appropriate overarching outcome indicators for this domain? Are there any other outcome indicators that should be considered?
	     	
14.	Would indicators such as those suggested at para 3.20 (page 24) be good measures of NHS progress in this domain? Is it feasible to develop and implement them? Are there any other indicators that should be considered for the future?
	     	
15.	As well as developing Quality Standards for specific long-term conditions, are there any cross cutting topics relevant to long-term conditions that should be considered?
	     	
Domain 3 - Helping people to recover from episodes of ill health or following injury	
16.	Are the suggestions at para 3.28 (page 27) appropriate overarching outcome indicators for this domain? Are there any other indicators that should be considered?	     	
17.	What overarching outcome indicators could be developed for this domain in the longer term?	     	
18.	Is the proposal at paras 3.30-3.32 (page 28-29) a suitable approach for selecting some improvement areas for this domain? Would another method be appropriate? 	     	
19.	What might be suitable outcome indicators be in these areas?	     	
Domain 4 - Ensuring people have a positive experience of care	
20.	Do you agree with the proposed interim option for an overarching indicator set out at para 3.43 (page 32)?
	     	
21.	Do you agree with the proposed long term approach for the development of an overarching outcome indicator set out at para 3.44 (pages 32-33)? 
	     	
22.	Do you agree with the proposed improvement areas and the reasons for choosing those areas set out at para 3.45 (pages 33-34)?  
	     	
23.	Would there be benefit in developing dedicated patient experience Quality Standards for certain services or client groups? If yes, which areas should be considered?	     	
24.	Do you agree with the proposed future approach for this domain, set out at paras 3.52–3.54 (pages 36-37)?

	     	
Domain 5 - Treating and caring for people in a safe environment and protecting them from avoidable harm	
25.	Do you agree with the proposed overarching outcome indicator set out in para 3.58 (page 38)?	     	
26.	Do you agree with the proposed improvement areas proposed at para 3.63 (page 39-40) and the reasons for choosing those areas? 
	     	

GENERAL CONSULTATION QUESTIONS	
27.	What action needs to be taken to ensure that no-one is disadvantaged by the proposals, and how do you think they can promote equality of opportunity and outcomes for all patients and, where appropriate, NHS staff?
	     	
28.	Is there any way in which the proposed approach to the NHS Outcomes Framework might impact upon sustainable development?
	     	
29.	Is the approach to assessing and analysing the likely impacts of potential outcomes and indicators set out in the Impact Assessment appropriate?	     	
30.	How can the NHS Outcomes Framework best support the NHS to deliver best value for money?	     	
31.	Are there any other issues you feel have been missed on which you would like to express a view?	     	

ANNEX A: IDENTIFYING POTENTIAL OUTCOME INDICATORS	
Potential Indicators	
32.	What are the strengths and weaknesses of any of the potential outcome indicators listed in Annex A with which you are familiar?
	     	
33.	Are other practical and valid outcome indicators available which would better support the five domains?
	     	
34.	How might we estimate and attribute the relative contributions of the NHS, public health and Social Care to these potential outcome indicators?	     	
Principles For Selecting Indicators	
35.	Are the principles set out on page 48 and 49 on which to select outcome indicators appropriate? Should any other principles be considered?	     	

Please send your responses via email to:
nhswhitepaper@dh.gsi.gov.uk
or via post to:
Consultation Responses
Quality and Outcomes Policy Team
Room 602A, Skipton House
80 London Road
London
SE1 6LH

Your can also respond to this consultation by coming along to one of our regional events for NHS staff and patients which will be held across the country, details of which will be posted on the DH website shortly.