Non-clinical partner Ryan Smith explains how QOF is calculated and shares his tips on how practices can boost their income.
How many QOF points are there for 2022/23 and what are the Quality Improvement (QI) modules?
QOF for 2022/23 will consist of 635 points. There are 401 points available in the clinical domain, 160 in the Public Health domain and 74 in the Quality Improvement domain.
The QI modules for 2022/23 are Prescription Drug Dependency and Optimising Access to General Practice.
How is QOF value calculated?
The national value of a QOF point for 22/23 is £207.56. Practice list size and prevalence against national figures will determine your individual practice’s QOF payment.
The Contractor Population Index (CPI) is used to adjust your QOF payment according to the relative list size of your practice. For 2022/23, the average practice list size is 9,374. So, to calculate your CPI, use your practice list size and divide by 9374. Your practice baseline QOF point value will be £207.56 multiplied by your CPI.
Meanwhile, prevalence is calculated by the number of patients on your relevant registers. The more patients on any given register the more a QOF point in that clinical area is worth. This is to acknowledge the extra work you will have to do to achieve the targets set. You can find your practices prevalence percentage for 2020 on https://www.gpcontract.co.uk/
What is exception reporting?
Exception reporting is now called Personalised Care Adjustments. It is used as way for practices to exclude eligible patients from QOF indicators or domains. This may happen where:
- The investigative service or secondary care service for the patient is unavailable,
- The intervention described in the indicator is clinically unsuitable,
- A patient has chosen not to agree to investigation or treatment, following a discussion with their HCP, which should be recorded in their notes,
- The intervention described in the indicator is clinically unsuitable,
- A patient hasn’t responded to recall (a minimum of two attempts, with at least one being via a letter. For cervical screening, this should be three attempts),
- A patient is newly registered/newly diagnosed in the last three months of the QOF year.
What is the key QOF activity to be aware of in 2022/23?
- There are changes to the serious mental illness domain, including a more comprehensive review and requirements for observation. This may or may not include speaking to relatives and/or carer.
- The Vaccination and Immunisation domain that includes children between 8-months-old and 5-years-old receiving the full vaccination schedule and 70-79 year olds receiving the shingles vaccine. You will need to have a tight control of recalls and registrations particularly in the child domains.
- Be aware of indicators with timed features. Both Heart Failure and Asthma need timely testing. Meanwhile, COPD and Diabetes have timely referral criteria.
- You need to ensure that indicators with timed referrals or personalised care adjustments are dealt with quickly. Check timed referrals and timed care adjustments, e.g. spirometry, echocardiogram, structured education programmes, vaccination and immunisation and so forth.
My tips for how to get the most out of QOF
- Embrace new ways of working to increase QOF funding. Use technology as much as you can. For example, using text messaging and features such as Florey can help screen or monitor patients remotely via questionnaires). EConsult can be used as a triage platform.
- Tap into your wider network – your PCN, CCG/ICS or federation – to look for support in achieving QOF points and income.
- Using external companies, such as Ardens or Interface Clinical Services, can make processes more efficient.
- Remote working is now the norm. This can be difficult to manage in terms of encouraging staff to capture QOF domain data but there are benefits too. For example, with increased patient contact there is more opportunity to obtain information that’s not already captured.
- Since there is less footfall in practices self-reporting of patient obs (such as blood pressure or weight) is more important. Ensure all staff are aware of the QOF pop-up boxes and alerts so they can ask the relevant questions when patients do come into the practice. Every contact is an opportunity too important to miss.
Ryan Smith is a non-clinical partner and strategic manager at Kenilworth and Warwick PCN
Ryan Smith is speaking at our Management in Practice event in Liverpool on 7 July on how to maximise QOF income and why QOF management should be led by non-clinicians. Sign up here to get your free place.
Can’t make it to Liverpool? Click here to find your nearest event
