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QOF achievement remains high despite Covid-induced decline

by Beth Gault
21 August 2020

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GP practices earned fewer points on average under the Quality and Outcomes Framework (QOF) payment system last year, though achievement still remained high despite the pandemic.

The average QOF points score for practices was 533.9 for the year ending 31 March 2020, out of a maximum 559. This was down five points from 539.2 in 2018/19.

GP leaders said the high achievement was testament to the ‘astonishingly hard’ work of GPs despite the extra pressures caused by the Covid-19 pandemic.

The decline would have equated to an average loss of £1,000 per practice, but NHS England has committed to topping up practices’ funding to the same as 2018/19.

The proportion of practices that achieved the maximum QOF score dropped from 13% in 2018/19 to 7.3% in 2019/20. Achievement was assessed across 68 indicators.

The size of the QOF remained unchanged for 2019/20, at 559 points, however the value of each point increased from £179.26 in 2018/19 to £187.74 in 2019/20.

‘High level of achievement’

Swindon GP and QOF expert Dr Gavin Jamie said: ‘This is the first time I’ve seen the points drop. Almost six points, that’s on average around £1,000 per practice.

‘But we’re still getting a very high level of achievement across the board against something that is generally more challenging this year.’

NHS England has guaranteed to top up practices’ QOF payments if the points were impacted by Covid.

However, Dr Jamie added the drop in points might also be attributed to a harder framework.

He said: ‘Certainly we’re seeing drops in achievement around diabetes, and that actually probably is around the QOF getting harder last year as well as Covid. There were quite big changes towards the diabetes indicators, some of the thresholds were getting harder, some of the blood pressure thresholds were getting harder as well, so QOF was genuinely more challenging.’

Changes to the QOF in 2019/20 included the introduction of peer-review meetings within PCNs.

Missed funding

It comes after concerns that practices will miss out on thousands of pounds in funding that they would have obtained through increasing their point scores. GPs said they often tend to make a ‘big push’ on QOF work at the end of the financial year, but due to the pandemic much of this work had stopped.

Doncaster GP and LMC medical secretary Dr Dean Eggitt said though the drop in points was ‘pretty significant’, it ‘still shows that practices worked astonishingly hard during that Covid period’.

He said: ‘They were doing double the amount of workload on top of QOF and continued to see sick people.

‘And actually it shows that people have been working hard through the entirety of the year, much to the contrast of what people assumed.’

But Dr Eggitt said he still feared practices would miss out on funding they deserve, because if they earnt less than last year they will only be topped up to match the previous year’s cash

He said: ‘When you protect income in a practice and say we’re going to pay you based on the previous year’s achievement, there’s always going to be winners and there’s always going to be losers.’

‘Testament to practice staff’

Kent LMC chair Dr Guarav Gupta added: ‘Practices are doing well with such a small drop if you think about 10% of the year being wiped off. It means that practices have worked really hard to provide high quality care to their patients in difficult circumstances.

‘I think it’s a testament to GPs and practice staff that they have done so well and I hope that practices will not be penalised for any drop in QOF points as a result of Covid because practices have continued to respond to Covid in the best way they can.’

It comes as GPs will have to work harder for QOF income in 2020/21 as protected points have been reallocated so that practices concentrate on expanding flu vaccinations and catching up on cervical screening.

A version of this article first appeared in our sister title Pulse.