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Reducing ‘avoidable’ appointments will now be part of QOF

by Anna Colivicchi
5 April 2023

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Reducing ‘avoidable’ appointments will be part of QOF activity for GP practices from April, according to new contractual guidance.

The latest QOF guidance, as well as the full legal document for the new GP contract imposed by NHS England, said that work to reduce avoidable appointments will include a focus on ‘high intensity service users.’

The indicator is one of the ‘quality improvement’ indicators and is worth 15 points – around £3,250 to the average practice – and practices need to ‘demonstrate improvement in reducing avoidable appointments’.

The guidance suggests that to do this practices should:

  • use ‘business intelligence tools’ or collect data themselves, to understand demand and activity by day and time of day;
  • ‘develop an understanding of the telephone queue’ either by extracting data from their cloudbased telephony system or asking staff to collect data over a period;
  • use the data to understand peaks of activity and match capacity to demand.

ICBs should support practices to access ‘effective tools’ to enable this data on demand and capacity to be more easily understood by GPs.

The guidance said: ‘It will enable clinical time to be spent on managing more appropriate appointments, enabling more time with complex patients and contribute to more manageable workloads and GP retention.

‘The starting point for addressing avoidable appointments is understanding current activity.’

It will also help building a ‘shared understanding across the system about the impact on general practice workload.’

The guidance added: ‘Where BI tools are available, practices may find it helpful to have training or support in how to most effectively use the tool.

‘Clinicians working together to define which appointments may be avoidable can enable a practice to review its care navigation and triage processes to give patients more appropriate services.’

Speaking at a webinar last week, Dr Clare Bannon, a member of the GPC executive, explained that this new QOF indicator is also ‘about looking at engaging with the new telephone systems.’

She said: ‘So there’s digital telephone systems coming in that will give us more information about our call rates, it’ll enable us to have call queueing, it’ll enable us to see exactly what the demand is like throughout the day.

‘And that QOF quality improvement indicator is about using that data and looking at staffing levels and looking at when the busy times during the day are and making changes to improve access in that way.’

NHS England imposed the contract with a focus on access, and the imposition has led to talk of potential industrial action, with GPC England convening a special meeting on 27 April to discuss next steps.

The imposed contract also contains a ban on asking patients to call back at a different time but last week the GPC confirmed this will not mean having to offer them an appointment on first contact.

A version of this story was first published on our sister title Pulse.