BMA - Quality and Outcomes Framework guidance

BMA - Quality and Outcomes Framework guidance

September 23, 2013

 

QOF guidance 2013-2014 according to nation

This page outlines the changes to the Quality and Outcomes Framework (QOF) for 2013-2014 for England only.
Separate guidance for Scotland and Wales is available to download:
Northern Ireland QOF guidance for the GMS contract 2013-2014 (PDF)
Scottish QOF guidance for the GMS contract 2013-2014 (PDF)
Wales QOF guidance for the GMS contract 2013-2014 (PDF)

QOF guidance 2013-2014 (sixth revision)

Changes to Quality and Outcomes Framework

As part of the 2013-2014 GMS contract changes, the Department of Health (DH) have imposed a number of changes to the QOF effective from 1 April 2013.
Following breakdown in negotiations, the Government consulted on changes to the GMS contract, including implementing all of the National Institute for Clinical Excellence (NICE) recommended changes to the QOF, the removal of the organisational domain and increasing thresholds for all continuing fraction indicators in line with the 75th centile of achievement phased in over two years.
Although the General Practitioners Committee (GPC) did not agree to or support these changes, we have been consulted on the wording of the QOF guidance.
Read our consultation response
As several of the changes have been imposed against the GPC's recommendations despite our concerns over workload and cost to practices, we are producing a guide to help practices. In this guide we explain how the new indicators could potentially impact on practices as well as what to do to fulfil them.
Read our GP survival guide

The full guidance and summary of changes are available to download in pdf format below.

The key changes

• The implementation of NICE recommended replacements, new indicators and retirements (The GPC did not agree to the implementation of all new and replacement indicators - our reasoning for this is set out in the consultation response):
  
  - the introduction of 12 new NICE recommended clinical indicators, including one new clinical area for rheumatoid arthritis
  
  - the delayed introduction to 201420-15 of two new NICE recommended clinical indicators for cardiac and pulmonary rehabilitation (the points originally identified for these two indicators will be added to HYP003, HYP004 and HYP005 as a result of their delayed introduction)
  
  - the replacement of seven indicators with six NICE recommended indicators, focusing on depression, cancer, cardiovascular disease - primary prevention, blood pressure recording and smoking
  
  - the retirement of eight indicators (CHD10, BP4, DM2, DM10, DM22, DEP1, CKD2 and EP6) releasing 34 points to fund new and replacement indicators. (The GPC did not agree to the retirement of CKD2, EPILEPSY 6 and BP4)
  
  
• The introduction of a new public health domain.
• The removal of the organisational domain indicators not retained in the quality and productivity domain or moved into the public health domain. This releases 137.5 points to fund the NICE recommended indicators and four new enhanced services. (The GPC did not agree to this change).
• An increase in thresholds for all existing indicators, in line with the 75th centile of achievement phased in over two years. For 2013-2014, this applies to 20 indicators and the remaining indicators from 2014-2015. From 2015-2016 thresholds will change on an annual basis in relation to practice achievement. (The GPC did not agree to this change)
• The thresholds for the two new indicators on increasing physical activity for patients with hypertension (HYP004 and HYP005) will be phased in over two years. (The GPC did not agree to the introduction of these two new indicators)
• The removal of the current end-of-year overlap for most indicators by changing the indicator timeframe from 15 to 12 months or 27 to 24 months). (The GPC did not agree to this change)
• Amendments to indicator wording for a number of indicators
• Updating the Contractor Population Index (CPI) in order to reform the list size weighting.

In addition to the key changes listed above, a number of changes have been made to the QOF guidance.

• References to Primary Care Trusts (PCTs) and Primary Care Organisations (PCOs) have been removed and updated to reflect NHS England's role.
• Indicator wording has been updated to include important information within the business rules or guidance ie. specifying age ranges and timeframes or whether the care described should be delivered in the context of a face-to-face consultation.
• The reordering and renumbering of all indicators to improve the flow of the document and to reflect that a number of changes have been made to indicator wording.
• Full guidance on exception reporting is now included

As there are also a number of miscellaneous changes to the QOF for 2013-2014, a spreadsheet detailing the updated indicator IDs, changes to indicator wording and timeframe is also available to download below.

NICE menu of recommended changes to the QOF

On 1 August 2012 the National Institute of Health and Clinical Excellence (NICE) published the 2013-2014 menu of QOF recommendations.
Get full details of the NICE recommendations and relevant supporting documents

Supporting information

The detailed QOF guidance 2013-2014 and a 'Summary of 2013-2014 QOF indicator changes' of the indicator wording, points and thresholds are available in the downloads section below.
Get details of the business rules process from NHS Employers
Get the business rules from the Primary Care Commissioning website
Get the annual QOF results (England) from the NHS Information Centre for Health and Social Care

Related pages

Previous revision 2012-2013 to QOF guidance
Contract imposition survival guide

Downloads

QOF guidance 6th revision 2013-2014 (PDF 827k)
Summary of 2013-2014 QOF Changes (PDF 25k)