QIF & QOF

QOF update for practices including achievement and required plan

The CCG has received some queries regarding this year’s Quality Outcomes Framework (QOF) and the potential changes in achievement levels with the new business rules update (V.45) that practices may now be starting to see. The QOF updated guidance that was released recently is available here and outlines the approach to QOF for the remainder of this financial year.

There have been some changes in a number of indicators that have come into effect for 2020/21. Please note however that these indicators are subject to income protection for this year and whilst performance will be monitored through CQRS, this will not be used for payment purposes. You can find a list of income protected indicators on Page 18 Table 6 of the guidance as well as detailed clinical guidance for new indicators from Page 22.

To be eligible for income protection practices will need to:

Agree a plan for QOF population stratification with their commissioner during October and November 2020. This approach should include the identification and prioritisation of the highest risk patients for proactive review including:

Those most vulnerable to harm from COVID-19; evidence suggests that this includes patients from BAME groups and those from the 20% most deprived neighbourhoods nationally (LSOAs)
those at risk of harm from poorly controlled long-term condition parameters;
those with a history of missing reviews.

Commit to making referrals to existing and any new weight management programmes and support offers commissioned during the year where this is identified as a key health and wellbeing intervention in these discussions.

Therefore, please can we ask that practices have a plan/confirmed approach ready for submitting via eDEC when this is required. The CCGs will not require to see all practice plans prior to submission, but please discuss with a member of the primary care team if you are concerned or would like clarification regarding your plan/confirmed approach.

If you are experiencing any other issues relating to your QOF data that do not relate to the indicator changes within QOF as described above, your Data Quality Specialists will be able to support with this.

QOF update for practices including achievement and required plan

The QOF updated guidance that was released recently and is available here https://www.england.nhs.uk/wp-content/uploads/2020/09/C0713-202021-General-Medical-Services-GMS-contract-Quality-and-Outcomes-Framework-QOF-Guidance.pdf outlines the approach to QOF for the remainder of this financial year.

To be eligible for income protection practices will need to:

Agree a plan for QOF population stratification with their commissioner during October and November 2020. This approach should include the identification and prioritisation of the highest risk patients for proactive review including: b. those at risk of harm from poorly controlled long-term condition parameters;
c. those with a history of missing reviews.
a. Those most vulnerable to harm from COVID-19; evidence suggests that this includes patients from BAME groups and those from the 20% most deprived neighbourhoods nationally (LSOAs)
Commit to making referrals to existing and any new weight management programmes and support offers commissioned during the year where this is identified as a key health and wellbeing intervention in these discussions.

Therefore please can we ask that practices have a plan/confirmed approach ready for submitting via eDEC when this is required. The CCGs will not be requiring to see all practices plans prior to submission but please discuss with a member of the primary care team if you are concerned or would like clarification regarding your plan/confirmed approach.

Quality Outcomes Framework (QOF) payments 2019/20

Applies to all Staffordshire and Stoke-on-Trent practices

As part of the commitment in the letter from the CCG on 13 March, Practices will be receiving a top up payment to either 2018/19 achievement levels of 2019/20 + 2 weeks pro rata levels. Payments will be made via the August pay-run via Exeter.

Quality Improvement Framework (QIF) payments 2019/20

North Staffordshire and Stoke-on-Trent practices only

As part of the commitment in the letter from the CCG on 13 March, Practices will be receiving reconciliation of QIF payments to either 2018/19 achievement levels of 2019/20 + 2 weeks pro rata levels (inclusive of any audits). Reconciliation payments should be in practices accounts by Friday 31 July 2020.