Quality and Outcomes Framework

Policies and Procedures - Guide for Practices

For the first time, the new GMS contract will bring with it legal requirements relating to quality for primary care contractors. At the same time, however, the new contracts, both GMS and PMS, will offer substantial incentives and rewards for those practices providing the highest quality services to patients.

Subject: Amended Quality and Outcomes Framework Guidance (26 August)

Dear all,

The Quality and Outcomes Framework guidance has now been revised to include minor amendments and clarifications, and to amend the Read codes. The revised guidance replaces the original version published in Investing in General Practice - Supporting documentation (the blue book).

The amended guidance is available on the GPC website at the following location: http://www.bma.org.uk/ap.nsf/Content/QualityOutcomes

The main change is that the revised guidance does not include preferred Read codes. The Read codes have been replaced by the 'Logical Query Indicator Specification' and the 'Dataset and Business Rules'. This was done in order to minimise confusion, to prevent the misconception that there are 'preferred' codes and to recognise the importance of capturing clinical interaction properly. These Read codes are an NHS standard and must be used to enable QOF reporting. These codes will have been added to your system by your supplier.

Other minor amendments and further clarification have also been provided for a number of the indicators. A list of amendments can be found on the GPC website at the following location: http://www.bma.org.uk/ap.nsf/Content/Q%26OFrevisions0804

The Statement of Financial Entitlements (SFE) 2004/05 will be updated shortly through amendment directions to reflect any of the amendments that require it. Further information will be issued shortly.

It is not intended that any substantial changes will be made to the QOF before April 2006, other than in exceptional circumstances e.g. where there is a sudden change in the law that would render a particular indicator inappropriate. These changes will be discussed by the Quality and Outcomes Framework expert review group, which is currently being established. Further information is available in the General Practitioners Committee guidance, Focus on Review of Quality and Outcomes Framework available on the GPC website at the following location:

http://www.bma.org.uk/ap.nsf/Content/FocusReviewQ%26OF

Please can I ask LMCs to publicise this information to practices locally. Best regards, Felicity Espley GPC Secretariat

They will do this using the new Quality and Outcomes Framework – QOF for short. The QOF is a system of standards, incentives and assessment relating mainly to the essential and additional services. There is a growing range of practical help for PCTs and practices to support quality improvement.

Main Support Web Sites

NatPaCT website - http://www.natpact.nhs.uk/

QOF Pages

http://www.natpact.nhs.uk/primarycarecontracting/16.php

The following information is reproduced from the above site…

Links to Support & Resources

• Quality and Outcomes Framework Annual Reviews - a Short Briefing for PCT Leaders
• Your Questions Answered on Quality
• QOF Assessors Training Part 1 - Materials, Delegate pack, Modules
• Guidance for Quality and Outcomes Framework annual review process
• ScHARR
• Prevalence guide
• Primary Care Contracting Collaborative
• Quality Improvement Skills for Primary Care (QuISP)
• The National Primary Care Collaborative
• Quality & Outcomes under the new GMS contract
• The Quality Management and Analysis System (QMAS)
• Slides demonstrating use and analysis of QMAS data
• Templates to aid in planning the QOF review process

Quality and Outcomes Framework Annual Reviews - a Short Briefing for PCT Leaders

Summary of QOF Annual Reviews and associated processes, prepared by NatPaCT to highlight key issues for PCT Boards, drawing on, but not replacing material published by the Department of Health. QOF Annual Reviews Briefing for PCT Leaders

Your Questions Answered on Quality

Material drawn from Department of Health agreed Frequently Asked Questions, collated by NatPaCT. pdf version of Quality Q&As

QOF Assessors Training Part 1 – Materials

This section gives access to the various materials relating to the QOF Assessors Training Part 1. Included in this online resource are - presentations, delegate pack and Skills Modules from the training events.

---

Presentations from QOF Assessors - Training Part 1

• Introduction
• Principles Purpose and Process of Quality Review Visits
• QMAS
• Evidence Based Work and Data Analysis
• Scenario Workshops
• Final Report
• QOF Basics - Domains, Evidence & Local Frameworks
• Primary Care Contracting Basics for Lay Assessors
• The Lay Assessor role

---

Delegate Pack from QOF Assessors - Training Part 1

• Contents page
• Summary of Modules
• Day 1 Workshop - Checklist
• Glossary of clinical terms used in QOF
• QOF process time line
• QOF Assessment Visits - process guide
• Tips for quality assuring QOF Annual Review visits
• Suggested post-visit report template
• Confidentiality and the QOF Annual Review process
• GMS IT QMAS Bulletin - An Introduction to QMAS
• Useful QOF Web addresses
• List of evidence for non-clinical domains
  NOTE You can edit and adapt this document for your own use if you download it, then Save it with a new name to your PC or Network drive.
• QOF Case Study 1
• QOF Case Study 2
• QOF Case Study 3
• Download all documents as a Zip file

---

QOF Assessor Training Part 1 - Skills Modules

• Module S1 - Personal skills for interviewing, listening and giving feedback (PowerPoint presentation)
• Module S2 - Group-oriented skills in chairmanship, time management and team-working (during the review visit) (PowerPoint presentation)
• Module S3 - Worksheet - following an audit evidence trail - Education and Training
• Module S3 - Worksheet - following an audit evidence trail - Medicines Management (E)
• Module S3 - An orientation to evidence based work - Trainer's Notes
• Module S3 - Information sheet - Evidence based work
• Module S4 - Collecting and analysing data (PowerPoint presentation)
• Module S4 - Data summary paragraph
• Module S5 - Skills in note making, summarising and report writing (Power-Point presentation

Guidance for Quality and Outcomes Framework annual review process

These documents form the basis of the training events for PCT QOF leads and QOF assessors which are currently underway, and comprise General Guidance on Annual QOF Review Process and Technical annexes to the annual QOF review process guidance, covering Assessor competencies and training, The visit, Dispute resolution, Pre-payment verification checks and Random counter-fraud check

§ Download the Guidance for Quality and Outcomes Framework annual review process

Also available is a report from the School of Health and Related Research at Sheffield University, which was commissioned to give DH independent advice on the review process. This advice had formed the basis for the DH guidance, although the two are not identical.

• Download the ScHARR report

Prevalence Guide

This user-friendly guide on how prevalence affects QOF payments explains why prevalence is used, how the calculations work, and where to go if you have any questions. The guide is available electronically in Acrobat pdf format by clicking the link below, but it is also designed to print out well and can be used in hard copy.

For further support on implementing all aspects of the QOF, go to: www.npdt.org

• Download the Prevalence Guide

Quality Improvement Skills for Primary Care (QuISP)

The QuISP programme will deliver training and practical tools in improvement techniques to primary care managers and clinicians. The first "train the trainers" programmes will take place at the end of July 2004, followed by the second by the end of October. These programmes are targeted at clinicians and NPDT Centres are currently recruiting to these programmes.

§ NPDT’s NGMS/PMS support pages

The National Primary Care Collaborative (NPCC)

Helping practices improve standards in chronic disease management (initially diabetes and COPD). Improvements in these clinical areas will help practices secure quality points under the Quality and Outcomes Framework (QOF).

• NPDT’s Primary Care Collaborative pages

Quality & Outcomes under the new GMS contract - NHS Confederation/NatPaCT (June 03)

• Quality & Outcomes under the nGMS contract

The Quality Management and Analysis System (QMAS)

A single, national IT system, giving GP practices and Primary Care Trusts objective evidence and feedback on the quality of care delivered to patients.

• The Quality Management and Analysis System (QMAS)

For the Quality & Outcomes Framework, the following policies and procedures are mentioned in the indicators:

· System for transferring and action on information about patients seen out-of hours.

· System to record messages and request for visits and the appropriate team member receives and acts on them.

· System for dealing with hospital reports and investigations that identifies the responsible clinician and ensures that any necessary action is taken.

· System for informing relevant team members about patients who have died.

· System for ensuring that all prescribed medication is entered into the patient record.

· System to alert the out-of-hours service to patients dying at home

· Arrangements for patients to speak to clinicians on the ‘phone during the working day.

· Procedure for removing patients from the list.

· Smoking cessation advice.

· Arrangements for backing up computer data, back-up verification, safe storage and authorisation for loading programmes onto computers.

· Decontamination and sterilisation.

· Calibration, maintenance and replacement of equipment.

· Fraud prevention.

· Carers’ policy.

· Emergency drugs.

· Repeat prescriptions.

· Medication reviews.

· Monitoring patients receiving injectable neuroleptic drugs.

· System for following up abnormal and inadequate smears.

· System for identifying and following up women who do not attend for cervical smears.

· Provision of emergency contraception.

· Pre-conceptual advice.

· Records summarising.

Return to the Top

Last Updated on Wednesday, 01 September 2004
By John BakerEmail: jb@devonlmc.org