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 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 attendancesamendments to indicator wording for CHD9, CHD10, CHD14, Stroke12, DM26, DM27, DM28 and DEM3inclusion of telephone reviews for Epilepsy 6Quality 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.
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 COPD10lower 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.Summary of Allocation of Clinical Domain points
CLINICAL DOMAIN 2012/13 QOF POINTS
- Secondary prevention of coronary heart disease 48
- Cardiovascular disease – primary prevention 13
- Heart failure 29
- Stroke and Transient Ischaemic Attack 22
- Hypertension 69
- Diabetes mellitus 88
- Chronic obstructive pulmonary disease 30
- Epilepsy 14
- Hypothyroidism 7
- Cancer 11
- Palliative care 6
- Mental health 40
- Asthma 45
- Dementia 26
- Depression 31
- Chronic kidney disease 36
- Atrial fibrillation 27
- Obesity 8
- Learning disabilities 7
- Smoking 73
- Peripheral arterial disease 9
- Osteoporosis : secondary prevention of fragility fractures 9
Source: http://www.nhsemployers.org The full QOF guidance is available to download from this site