QIF & QOF

Cancer Care Reviews – Changes to QOF requirements 2021/22

In recognising the important role that primary care plays to support people after a cancer diagnosis, changes have been made to 2021/22 Quality and Outcomes Framework (QOF) cancer requirements.

The changes focus on key times of need, when patients may feel vulnerable. These include:-

At the time of diagnosis (within 3 months)
After a patient has received acute treatment (within 12 months)

The QOF also specifies that practices should use Macmillan’s national, integrated electronic Cancer Care Review template to support a well-structured review.

Macmillan has provided a number of resources to support primary care professionals in meeting the QOF requirements and delivering improved care and support for cancer patients.

Resource topics include:-

For those GP practices who signed up to the Staffordshire Cancer LIS – Enhanced Cancer Care Reviews in 2018 and released practice nurses to undertake training on how to undertake a Cancer Care Review using the Macmillan template, we are pleased to announce that Macmillan have continued the funding which means that those practices can continue to claim an additional payment for each Cancer Care Review completed. If you need more information about this please contact: – angela.crutchley@staffsstokeccgs.nhs.uk.

QOF Achievement 2020/21 – Update on Osteoporosis, Mental Health and Heart Failure Register Size issues with 2020/21 QOF data

As previously communicated, issues have been identified with three registers that were used in the QOF 2020/21 Achievement calculation. To resolve the issues identified and ensure that GP practices are paid correctly, NHS Digital have re-collected QOF data, working with the GP Clinical System suppliers. The new extraction is currently being reviewed to validate the data before it is loaded into CQRS for the QOF calculation to be undertaken. We expect to share the timescales for the calculations expected this month within CQRS on Wednesday 12 May.

Actions – Once the review to validate the data has been completed, the CQRS team will communicate the date that declarations are expected to commence.

As previously communicated, the following actions are required by practices and commissioners:

No further declarations or approvals for QOF should be made within CQRS until further notice, any approvals already processed will be reverted during the recalculation
Following the recalculation of QOF achievement practices and commissioners will be required to re-declare and re-approve their QOF achievement.

See link for contact details for support and other services impacted.

QOF 2021/22 (Acceptance of offer on CQRS and declaration of achievement data)

The QOF 2021/22 service has now been offered out to practices. Please log into CQRS and accept the offer prior to 26 March to avoid any delays with your aspiration payments. Please ignore this if you have already accepted the QOF21/22 service that has been offered to your practice.

This message contains important information about the Quality and Outcomes Framework (QOF) 2020/21 extraction and calculations.

The timetable below shows the dates for the upcoming QOF year-end 2020/21 extract

Extraction window	Thursday 1 April to Friday 2 April (2 days)
Achievement and Aspiration calculations	Tuesday 6^th April
Achievement available to view and declare in CQRS	By Wednesday 7^th April

Access to the following CQRS reports will be temporarily disabled on 6 April 2021 to allow the calculations to complete uninterrupted:

All QOF 2020/21 achievement data should be checked prior to declaration.

Instructions on how to check the extracted data under the Data Submission Tab can be found here.

Update on QOF changes for 2021/22

QOF requirements have been published. QOF for 2021/22 will be based on the indicator set already agreed for 2020/21, with very limited changes only. The reinstating of QOF in full will support the recovery of long-term condition management. Changes to the previous version are highlighted in yellow. This information has also been sent directly to practices by GMAST.

Update on vaccination and immunisation changes for 2021/22

All vaccine and immunisation programmes will be supported with an automated data extraction and monthly payment via CQRS from May/June 2021, with the exception of HPV which will remain a manual service for 21/22.

All practices will need to take up vaccination and immunisation services on CQRS, to ensure accurate and timely payment.

The Childhood Immunisation Target DES will be retired on 31 March 2021 and a new vaccination and immunisation domain in the Quality and Outcomes Framework (QOF) introduced for 2021/22.

Link: https://www.england.nhs.uk/wp-content/uploads/2021/03/B0434-letter-update-on-vaccination-and-immunisation-changes-for-21-22.pdf

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.