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Practices can’t assume income protected indicators bring in same QOF pay as for 2023/24, guidance says

by Rima Evans
11 April 2024

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Practices may not receive exactly the same QOF payment in 2024/25 as they did last year when it comes to ‘income protected’ indicators, guidance has warned.

NHS England has confirmed in its recently published latest QOF guidance that an additional 13 indicators will be protected this year taking the total that won’t be based on practice performance to 32, which are worth 212 points in total.

However, it said that income protection does not mean that ‘the payment amount will be the same in 2024/25 as in 2023/24′.

‘QOF earnings will continue to be subject to prevalence adjustments [and] list size variation, with these being based on 2024/25 figures,’ the guidance said.

‘Therefore, the final payment amount may be different’ it added.      

The value of a QOF point will also change for 2024/25 rising to £220.62 from £213.43.

Points given for protected indicators in 2024/25 will match those achieved last year, NHS England has further explained. ‘This means that practices will not be penalised for falling performance within the income protected indicators, but neither will they be rewarded for improvements in those indicators’.

NHS England has also set out how achievement will be calculated where practices are new or have merged (see box below).

Similar to last year, practices will still be expected to maintain the disease registers and accurately code patient records with up-to-date information on diagnoses.

Information on diagnoses will continue to be extracted by GPES to calculate prevalence. The guidance warned practices that ‘failure to maintain the registers will have an impact on prevalence adjustments and therefore will impact on practice income at the end of the financial year’.

Adding to the disease register indicators already subject to income protection in 2023/24, the following indicators will also now be income protected for 2024/25:

  • AST008: Recording smoking status of patients with asthma (6 points).
  • COPD014: Referring patients with COPD to a pulmonary rehabilitation programme (2 points).
  • MH021: Providing physical checks to mental health patients, such as smoking status, alcohol consumption and BMI (6 points).
  • DEP004: Reviewing patients with a new diagnosis of depression (10 points).
  • SMOK005: Offer of support to smokers with respiratory or certain other physical and mental health conditions (25 points).
  • CAN004: Cancer patients who have had a Cancer Care Review within 12 months of diagnosis (6 points)
  • CAN005: Cancer patients who have had the opportunity for a discussion and informed of the support available from primary care, within three months of diagnosis (2 points).    
  • Quality Improvement domain:  All six indicators QI013, QI014, QI016, QI017, QI018 and QI019 that relate to optimising demand and capacity in general practice and workforce and wellbeing (74 points).

In respect of the Quality Improvement indicators, NHS England has said this year practices will not be required to make any ‘formal submission of plans nor evidence of professional network meetings that have taken place’.

Last year, the completion of reporting templates and holding peer review meetings were a requirement of meeting the QI targets in both the workforce and wellbeing and optimising access areas.

How achievement will be calculated for income protected indicators in:

Merging practices – the combined 2023/24 performance, list and prevalence data for the practices that merged will be used to calculate new practice data that can be used in 2024/25. In some cases, the merging may be complex enough that this is not possible. In this case, it is proposed to use ‘the higher performance of the original practices or 2024/25 data for list and prevalence adjustments’.

New practices – they will be paid  based on actual performance in 2024/25, using list and practice adjustments from 2024/25.

Practices splitting into multiple practices – they will be paid based on the 2023/24 performance of the practice they were created from. The 2024/25 list and 2024/25 prevalence adjustments will be used.

Source: NHS England