Operational Standards, National Quality Requirements and Never Events, Section B Part 8.2: Operational Standards Ref Operational Standards Threshold (2015/16) Method of Measurement (2015/16) Consequence of breach Timing of application of consequence Applicable Service Category RTT waiting times for non-urgent treatment E.B.1 Percentage of admitted Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 90% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £400 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies E.B.2 Percentage of Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 95% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £100 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies E.B.3 Percentage of Service Users on incomplete RTT pathways (yet to start treatment) waiting no more than 18 weeks from Referral Operating standard of 92% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches at the end of the month exceeds the tolerance permitted by the threshold, £150 in respect of each excess breach Monthly Services to which 18 Weeks applies non-
surgery threshold E.B.10 Percentage of Service Users waiting no more than 31 days for subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of 98% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.11 Percentage of Service Users waiting no more than 31 days for subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R Cancer waits – 62 days E.B.12 Percentage of Service Users waiting no more than two months (62 days) from urgent GP referral to first definitive treatment for cancer Operating standard of 85% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.13 Percentage of Service Users waiting no more than 62 days from referral from an NHS screening service to first definitive treatment for all Operating standard of 90% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that Quarterly A CR R
relevant month E.B.S.7a All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 30 minutes >0 Review of monthly Service Quality Performance Report £200 per Service User waiting over 30 minutes in the relevant month Monthly A+E E.B.S.7b All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 60 minutes >0 Review of monthly Service Quality Performance Report £1,000 per Service User waiting over 60 minutes (in total, not aggregated with E.B.S.7a consequence) in the relevant month Monthly A+E E.B.S.8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes and no longer than 30 minutes >0 Review of monthly Service Quality Performance Report £20 per event where > 30 minutes in the relevant month Monthly AM E.B.S.8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes and no longer than 60 minutes >0 Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with E.B.S.8a consequence) in the relevant month Monthly AM E.B.S.5 Trolley waits in A&E not longer than 12 hours >0 Review of monthly Service Quality Performance Report £1,000 per incidence in the relevant month Monthly A+E E.B.S.6 No urgent operation >0 Review of monthly Service £5,000 per incidence in Monthly A
should be cancelled for a second time Quality Performance Report the relevant month CR VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE, as defined in Contract Technical Guidance 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Monthly A Publication of Formulary Continuing failure to publish Publication on Provider’s website Withholding of up to 1% of the Actual Monthly Value per month until publication Monthly A MH MHSS CR R Duty of candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident in accordance with Clause 68B Review of monthly Service Quality Performance Report Recovery of the cost of the episode of care, or £10,000 if the cost of the episode of care is unknown or indeterminate Monthly All Completion of a valid NHS Number field in mental health and acute commissioning data sets submitted via SUS, as 99% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect Monthly A MH MHHS
Reporting Period Format of Report Timing and Method for delivery of Report Application National Requirements Reported Centrally As specified in the list of omnibus, secure electronic file transfer data collections and BAAS schedule of approved collections published on the HSCIC website to be found at where mandated for and as applicable to the Provider and the Services As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance Small Providers National Requirements Reported Locally Activity and Finance Report [For local agreement, not less than quarterly] [For local agreement] [For local agreement] Small Providers Service Quality Performance Report, detailing performance against Operational Standards, National Quality Requirements, Local Quality Requirements, Never Events and the duty of candour [For local agreement, not less than quarterly] [For local agreement] [For local agreement] Small Providers CQUIN Performance Report and details of progress towards satisfying any Quality Incentive Scheme Indicators, including details of all Quality Incentive Scheme Indicators satisfied or not satisfied [For local agreement, not less than annually] [For local agreement] [For local agreement] Small Providers Complaints monitoring report, setting out numbers of complaints received and including analysis of key themes in content of complaints [For local agreement, not less than annually] [For local agreement] [For local agreement] Small Providers Report against performance of Service Development and Improvement Plan (SDIP) In accordance with relevant SDIP In accordance with relevant SDIP In accordance with relevant SDIP Small Providers Summary report of all incidents requiring [For local agreement, not [For local agreement] [For local agreement] Small