Commissioning for Quality and Innovation (CQUIN)
Below are details of CQUINs developed with the support and input from GIRFT and its clinical leads.
Drinking, eating and mobilising (DrEaMing) CQUIN
GIRFT has supported a Commissioning for Quality and Innovation indicator measuring whether patients are supported to drink, eat and start being mobile after surgery. This original CQUIN for 2022/23 has now been updated and published for 2023/24.
Drinking, eating and mobilising (known as DrEaMing) is a key element of enhanced recovery programmes, helping to prevent post-operative blood clots and respiratory complications, and associated with a 37.5% reduction in postoperative length of stay (LoS), helping to reduce the backlog of patients waiting for surgery.
The updated CQUIN for 2023/24 includes a wider range of procedures and a revised threshold which continues to be challenging, but achievable. Providers are now encouraged to ensure that 80% of inpatients undergoing major surgery are supported to DrEaM within 24 hours of surgery.
DrEaMing is supported by the Perioperative Quality Improvement Programme, as well as the relevant Royal Colleges, and was highlighted in the GIRFT national report for anaesthesia and perioperative medicine. The new indicator applies to surgery delivered from 1st April 2023.
Follow the links at the bottom of this page to the NHS England CQUIN page where the guidance containing more information on the CQUIN indicator specifications and the procedures can be found, as well as the 23/24 OPCS coding guidance.
Pre-operative anaemia management CQUIN
GIRFT has worked with leading clinicians, supported by NHS Blood and Transplant, and the relevant Royal Colleges, to support the development of a Commissioning for Quality and Innovation (CQUIN) scheme specification for pre-operative management of anaemia.
The CQUIN scheme specification is intended to support improved identification and treatment of iron deficient anaemia for patients undergoing major elective blood loss surgery.
Identifying anaemia with a blood test and providing patients with iron treatment is known to reduce the risks associated with blood transfusion and help patients return home sooner after surgery. These benefits to patients also help make NHS services more efficient and cost-effective.
CQUIN CCG10: Screening and treatment of iron deficiency anaemia in patients listed for major elective blood loss surgery aims to achieve this, building on existing NICE guidance and clinical audit work by NHS Blood and Transplant.
GIRFT is supporting the development of this CQUIN, linked to the publication of the GIRFT national report on anaesthesia and perioperative medicine, as part of efforts to reduce unwarranted variation.