In 2008 the Department of Health published ‘High quality care for all: NHS Next Stage Review’. This report includes a commitment to make a proportion of NHS providers’ income conditional on provision of quality and innovation through the Commissioning for Quality and Innovation framework (CQUIN). This article discusses the principles of the CQUIN payment framework and explores its relevance and impact in reducing pressure ulcer incidence. Personal experiences of negotiating CQUIN targets, implementing a strategy to reduce pressure ulcer incidence, and monitoring outcomes to provide evidence of quality improvements will be given.