The Clinical Outcomes Publication (COP) program has successfully published over 50 clinical indicators covering more than 550,000 patient episodes. The goals of COP are to stimulate clinical improvement, monitor consultant outcomes, reassure patients, and support shared decision making. The ambitions for 2016-2020 are to strengthen data quality, widen coverage to more specialties like ophthalmology and trauma, and publish at more granular levels. Keys to success include engaging clinical leaders, continuing investment, defining quality standards, and maximizing local stakeholder engagement in areas like commissioning, appraisal, and board oversight. The pathway to COP will focus on publishing team and consultant measures from existing and new specialties.

1. Clinical Outcomes Publication
(COP, formerly Consultant Outcomes Publication)
programme briefing 2016-2020

2. Clinical Outcomes Publication programme briefing 2016-2020 2
April 2016
Clinical Outcomes Publication project team
Jane Ingham HQIP chief executive officer
Danny Keenan
Kieran Mullan
HQIP medical director
Clinical lead
Louise Cleaver Project manager

3. Clinical Outcomes Publication programme briefing 2016-2020 3
Contents
Background..................................................................................................................................................................................................................................... 4
Our ambitions for 2016-2020......................................................................................................................................................................................................... 6
Key to success................................................................................................................................................................................................................................. 7
Pathway to Clinical Outcomes Publication..................................................................................................................................................................................... 9

4. Clinical Outcomes Publication programme briefing 2016-2020 4
Background
The Clinical Outcomes Publication programme, previously called Consultant Outcomes Publication, represents an ambitious endeavour which has successfully
demonstrated that transparency around clinical outcomes can be achieved at large scale across a wide range of clinical specialties. In 2015/16 the
programme supported the publication of more than 50 indicators from 13 distinct clinical specialties, covering more than 550,000 episodes of care.
Our key goals have been to:
 Stimulate improvement in the quality of clinical care
 Improve monitoring of consultant’s outcomes and governance arrangements for managing outlying data
 Reassure patients that the quality of clinical care is being actively monitored and improved
 Support shared decision making involving patients, including choice of provider, general practitioners, and consultants
 Further the cultural shift wherein medical specialty associations are becoming increasingly patient-focused
 Support the increasing involvement of individual trust executives, especially the medical directors, in understanding their role in assuring the quality of
their individual services and assuring that participation is as close to 100% as possible
 Support consultant appraisal and hence revalidation
 Promote and continue to develop standards for audits in relation to issues such as outlier management and data validation
 Support a wide range of audits in a positive improvement journey to enhance the overall quality of national audits to enable a wider range of data to be
published

5. Clinical Outcomes Publication programme briefing 2016-2020 5
More than 50
clinical indicators
More than 550,000
episodes of care
14 clinical
specialties

6. Clinical Outcomes Publication programme briefing 2016-2020 6
Our ambitions for 2016-2020
For 2016/17 onward we will build on these achievements by strengthening the quality of the data available and widening it even further to cover an even
more diverse array of clinical specialties. We will expand the publication of unit-level outcomes data in a way that makes sense clinically and led by the
clinicians with expertise in their respective areas. Ophthalmology, emergency laparotomy surgery, hip fracture care and major trauma care will be new
clinical areas added in the first year1
, as well as adding new measures to existing specialties. In successive years we will identify more audits that can join the
programme, and where appropriate support audit development to allow publication at a more granular level and with a wider number of measures being
published.
1
Participation in principle agreed with The National Emergency Laparotomy Audit (http://www.nela.org.uk/), The National Hip Fracture Database (http://www.nhfd.co.uk/),
The Trauma Audit & Research Network (https://www.tarn.ac.uk/) and The National Ophthalmology Database Audit (https://www.rcophth.ac.uk/standards-publications-
research/national-ophthalmology-database/)

7. Clinical Outcomes Publication programme briefing 2016-2020 7
Keys to success
Our experience to date has identified four key factors that can have a significant impact on the future success of the Clinical Outcomes Publication and those
stakeholders best placed to deliver success.
*NCDs: national clinical directors; MD: medical director; MDs: medical directors; CCGs: Clinical Commissioning Groups; CQC: Care Quality Commission; GMC:
General Medical Council; NHSI: NHS Improvement

8. Clinical Outcomes Publication programme briefing 2016-2020 8
Keys to success (continued)
For each area we have identified the following initiatives that will be used to support stakeholders in maximising their positive contribution:
Speciality-specific seminars
To ensure high profile support at a national level and positive engagement from professional leadership the National Clinical Directors will co-host a series of
speciality specific seminars with the NHS England Medical Director, bringing together a wide range of professional leadership figures in each field (including
Speciality Associations and Royal Colleges) to identify key steps for developing outcomes publication and agreeing action to ensure delivery in line with NHS
England goals.
Continuing investment
NHS England will continue to invest in the development of the Clinical Outcomes Publication programme, supporting audits to develop and improve their
methodologies and enabling necessary IT infrastructure and support to be in place.
Defining quality
To continue on our work in developing the Clinical Outcomes Publication Technical Manual published this year, HQIP will conduct further rounds of
development and consultation with the audit community on a rolling basis, identifying those areas of the manual where guidance can be further developed to
support a shared view of what high quality national clinical audit looks like.

9. Clinical Outcomes Publication programme briefing 2016-2020 9
Keys to success (continued)
Maximising local engagement
Experience of delivering COP to date has identified a number of key mechanisms through which activity by stakeholders can support the success of the
programme. These are commissioning, annual appraisal and revalidation and Board engagement. NHS England will seek to support positive progress in these
areas by working with the relevant stakeholders through existing and new initiatives. HQIP will inform the work of NHS England in these areas and provide a
mechanism for audits to identify existing and ongoing challenges being experienced on the ground. Potential elements of action will include:
 Commissioning: Identifying mechanisms to better enable commissioners to access COP data to support quality commissioning
 Annual appraisal and revalidation: Consider how Medical Directors can be supported to encourage participation in available national clinical audit
specifically as part of expectations for evidence for revalidation and annual appraisal
 Boards: Identify challenges for Boards seeking to utilise national audit data as part of their scrutiny role and consider whether additional guidance could
help ensure the positive participation of their organisations in national clinical audit
In addition, HQIP will continue to work in partnership with NHS England and CQC on an existing work stream that is developing the ability of national clinical
audit to provide high quality information on performance to inform regulatory understanding of organisational performance.
Pathway to Clinical Outcomes Publication
The programme will continue to support a focus on publishing team-based measures from existing and new specialties and at consultant level, where it
makes sense clinically and methodologically. We will aim to support national clinical audits to publish suitable data through NHS Choices and MyNHS in
addition to identifying other suitable candidates outside of the programme. Each audit will undergo a period of assessment to identify any development
needs ahead of publication. Where team measures are being published the audits will be supported to increase the granularity of their publications to reach
consultant level outcomes for different care pathways. Collectively this work will be described as the ‘pathway to COP’.
To support the process, HQIP will build on the Clinical Outcomes Publication assessment criteria contained within the COP Technical Manual to continue to
identify what is considered to be ‘gold standard’ in national clinical audits and will establish a transparent and independent process for assessing audits and
identifying when audits are suitable for participating in COP.
As part of the widening of the programme we propose rebranding as ‘Clinical Outcomes Publication’ and have used this branding throughout this document.