Practice manager Dr Jolande Bennekers provides practical tips to ensure you can meet QOF targets that have strict deadlines
NHS Digital’s definition of QOF is a voluntary annual reward and incentive programme for all GP practices in England, detailing practice achievement results.
But, how voluntary is a scheme if our practice income relies on it?
When QOF came into existence in the early noughties, it aimed to standardise and improve the quality of care to our patients and hoped to achieve this by rewarding good practice. Nowadays, we often wonder if this has not become more of a tick-box exercise instead.
The question we all seek an answer to is how to make the most of QOF, keep track of the time-sensitive indicators and achieve highest with the least effort.
Monitoring QOF achievements throughout the year
I have been involved with QOF for many years, tracking our achievements in a spreadsheet that automatically calculates how many more patients we need to reach the high target. I update this every week and share the results at clinical meetings and via regular updates to our staff.
This tracking of our achievements and sharing the results with our team has led us to the below QOF achievements for our practice:
- 2018/19 – 100%
- 2019/20 – 100%
- 2020/21 – close to 100% (both mental health and Non-Diabetic Hyperglycaemia were a few patients short of the higher target).
- 2021/22 100%.
Despite Covid, we reached the QOF targets.
However, as we all know, the targets changed and the Government expects even more from us for the same rewards. Primary care has repeatedly risen to the challenge to achieve well. Will we be able to this time?
Which are the time-sensitive indicators?
The indicators we need to keep a special eye on are those that have a limited time in which to achieve them for the fiscal year.
These indicators are:
AST006: Newly diagnosed asthma patients where spirometry or another objective test between 3 months before and 6 months after the diagnosis confirmed the diagnosis.
CAN004: Newly diagnosed cancer patients who had a cancer care review within 1 year of a new cancer diagnosis.
CAN005: Newly diagnosed cancer patients who received an offer of support in primary care within 3 months of a new cancer diagnosis. (Provision of information about cancer support services available in primary care).
COPD008: COPD patients whose MRC is higher than 3 and received a referral to pulmonary rehab within the current fiscal year.
DEP003: Newly diagnosed patients with depression who received a depression interim review between 10 and 56 days following the diagnosis.
DM015: Newly diagnosed diabetic patients who received a referral to diabetes structured education programme within 9 months after diagnosis.
HF005: Newly diagnosed patients with heart failure who had an echocardiogram or specialist assessment between 3 months before and 6 months to confirm the diagnosis.
Setting yourself up for success in QOF
- Start early.
- Have a robust recall system in place. We use birthday recalls but spread the months January to March over April to August instead. This leaves January to March to chase up on any outstanding reviews.
- Run recall searches every one to two weeks at least.
- Invite your patients for their reviews according to the recall process (by text, email, phone, letter).
- Code your invitations (first, second, third).
- Create a standard letter for patients who have not responded to the third invitation to stress that the review is important.
- Send the letter and exception report.
- Keep track of the time sensitive QOF indicators in the QOF searches in your clinical system.
- Create specific recall dates for time sensitive QOF indicators and run weekly searches. (This system is only as strong as the weakest link, as clinicians may forget to add the recall date).
- Involve your entire team and update everyone about your progress.
What tools can I use to help?
For example, AccuRxis a great communication tool. Depending on your level of subscription (from free to premium), you can communicate with your patients and other clinicians, too.
The basic form allows you to send texts to patients which save into the clinical record, and you can create your own message templates too. It also allows you to add a SNOMED code to the message sent. This is ideal for coding your review invitations (1st, 2nd, and 3rd).
Other than sending texts, AccuRx also has several standard questionnaires which a patient can answer, ranging from the Covid triage questionnaire, to smoking status, ethnicity, asthma and pill checks, and many more. Again, these can be saved and coded into the records.
AccuRx also has a video consultation platform. And it allows you to email other medical professionals via NHS mail. These emails also save into patients’ records and you can save the replies there, too.
Providers such as Ardens alsohave useful searches and templates. We have a search folder is for each time-sensitive QOF indicator, so we can more easily keep on top of these.
In summary, achieving well on QOF and keeping track of the time-sensitive indicators relies on the entire primary care team. We all play our role and should work together towards this aim. Good luck!
- Ensure you have a robust recall system in place, updated by all.
- Run your searches regularly, code well, and exception report where appropriate.
- Check your QOF data frequently (every one to two weeks at least).
- any tools available to you.
- Liaise with your PCN/ICS to find out if they agree to fund AccuRx and/or Ardens.
- Routinely share your achievement data with the team and encourage everyone to work to get those last few across the threshold.
Dr Jolande Bennekers is a retired GP who works as practice manager at Grimethorpe Surgery in Barnsley