GESTIÓN EN SALUD PÚBLICA: QOF guidance: QOF guidance 2012-2013 (fifth revision)

martes, 4 de septiembre de 2012

QOF guidance: QOF guidance 2012-2013 (fifth revision)

QOF guidance 2012-2013 (fifth revision)

As part of the 2012-2013 GMS contract changes, the General Practitioners Committee (GPC) and NHS Employers have agreed a number of changes to the quality and outcomes framework (QOF) effective from 1 April 2012.
The full guidance and summary of changes are available to download in pdf format below.

The key changes are:

the retirement of seven indicators (CHD13, AF4, QP1, QP2, QP3, QP4, QP5) releasing 45 points to fund new and replacement indicators
the replacement of seven indicators with eight NICE recommended replacement indicators, focusing on six clinical areas namely Diabetes, Mental Health, Asthma, Depression, Atrial Fibrillation and Smoking
the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (Atrial Fibrillation, Smoking, PAD and Osteoporosis)
the introduction of three new organisational indicators for improving Quality and Productivity which focus on accident and emergency attendances
amendments to indicator wording for CHD9, CHD10, CHD14, Stroke12, DM26, DM27, DM28 and DEM3
inclusion of telephone reviews for Epilepsy 6

Quality and productivity indicators

The six quality and productivity (QP) indicators covering outpatient referrals and emergency admissions have been agreed for a further year. Three new QP indicators on accident and emergency (A&E) attendances have been introduced for one year and are aimed at reducing avoidable A&E attendances. These indicators continue to be aimed at securing a more effective use of NHS resources through improvements in the quality of primary care.
Guidance on ’ Quality and Productivity Accident and Emergency ’ is available to download from the top right of this page. This guidance has been published separately and in advance of the national QOF guidance, to help practices and primary care organisations prepare for their implementation. This guidance has now been incorporated in the national QOF guidance document.

Miscellaneous changes

In addition to the above, a number of other changes have been agreed as follows:
Changes to the points values for the following indicators:

BP4 - reduced by eight points to eight points
BP5 - reduced by two points to 55 points
DM2 - reduced by two points to one point
DM22 - reduced by two points to one point
CKD2 - reduced by two points to four points
Smoking3 (now Smoking5) - reduced by five points to 25 points
Smoking4 (now Smoking6) - reduced by five points to 25 points

A number of threshold changes as follows:

raising all lower thresholds for indicators currently 40-90% to 50-90%,
raising all lower thresholds for indicators currently with an upper threshold between 70-85% to 45%,
a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31, and COPD10
lower and upper threshold changes for BP5, MH10 and DEM2
ASTHMA3 has been renumbered to ASTHMA10 following a change to the business rules to include a new exception cluster.

DEP4 has been renumbered to DEP6 following a change to the prevalence calculation to apply to all new diagnosis of depression from April 2006.
MH14 has been renumbered to MH19 following a change to the business rules to include an exclusion cluster for patients already diagnosed with CVD.
Records23 has moved into the clinical domain and the supporting business rules have been amended. This indicator is renumbered to Smoking7.
Education1 has been renumbered to Education11 due a change to the indicator wording.

Supporting information

The detailed QOF guidance 2012-2012 and a ’ Summary of 2012-2013 QOF indicator changes ’ of the indicator wording, points and thresholds are available to download below.
Details of the business rules process are available on the ’Developing the QOF Business Rules’ page on the NHSE website and the latest version of the business rules are available on the Primary Care Contracting website.

QOF results are published annually for the following countries, by the following organisations:

England - the NHS Information Centre for Health and Social Care
Scotland - the Information Services Division or contact Alistair Smith at nss.isdgeneralpractice@nhs.net.
Northern Ireland - the Department for health, social services and public safety or contact qofdataenquiries@dhsspsni.gov.uk.
Wales - NHS Wales

NICE menu of recommended changes to the Quality and Outcomes FrameworkOn 1 August 2011 the National Institute of Health and Clinical Excellence (NICE) published the 2012-2013 menu of QOF recommendations. For full details of the recommendations made by NICE along with any relevant supporting documents, visit the NICE website.