Learn the lingo series: "Commissioning Outcomes Framework (COF)"

Written by Jyothis George on 06 October 2012. Modified on 06 October 2012. Hits: 8673

AddThis Social Bookmark Button

The Commissioning Outcomes Framework (COF) will assess the quality of the services commissioned by Clinical Commissioning Groups (CCGs). It will become operational from April 2013, when CCGs take on full responsibility for commissioning.

This framework translates the outcomes indicators proposed in the NHS Outcomes Framework into indicators that are meaningful at a local level. Although it will be based on many of the indicators included the NHS Outcomes Framework, the COF is not simply a local version of the NHS Outcomes Framework. Instead, it will describe how CCGs will be held to account for the outcomes they achieve

in the specific locality that they hold commissioning responsibility for. Indicators include:

  •  Under 75 mortality rate from cancer;
  •  Rates of complications associated with diabetes; and
  •  Emergency readmissions within 30 days of discharge from hospital

The purpose of the COF is to:

  • make local improvements in quality and outcomes for patients;
  • hold CCGs to account for their progress in delivering these outcomes; and
  • provide clear, publicly available information on the quality of healthcare services commissioned by CCGs.

As it is intended to hold CCGs to account, the framework will only cover services which CCGs will commission and not the services that the NHSCB will commission, such as specialised services and primary care services.


In its annual assessment, the NHSCB will review the progress that individual CCGs have made against the COF. The new Calculating Quality Reporting Service (CQRS) will also provide monthly reports of in-year performance to the NHSCB on the achievement of CCGs against the COF and will make these reports available to the public upon request.

An independent advisory committee, set up by NICE, has been tasked with reviewing the COF following a recent public consultation. The committee, which consists of GPs, consultants, public health officers, patient representatives and medicines management, will publish a set of recommended indicators that should be included in the 2013/14 COF. The NHSCB will then publish the final set of indicators in Autumn 2012. The committee will also conduct an annual review into the COF, so that it is kept up to date and to ensure that the set of indicators best support improving outcomes for patients.

Implementation of the COF will be supported by a range of incentive mechanisms, such as CQUIN, to ensure individual outcome indicators show improvement. Individual CCGs will work with Health & Wellbeing Boards and Local Authorities to develop their local needs assessment and identify which aspects of the COF align with their local needs.

This summary from the Department of Health is helpful in visualising various domains.


Editor's note: This article has been generated from information provided by Sanofi Diabetes. Please also note that the article is not regularly monitored and may become less accurate over time as things evolve. Please see this section for the latest news on NHS, reforms etc.

Our latest tweets