NHS Employers and the General Practitioners Committee (GPC) agreed to reallocate 72 quality and outcomes framework (QOF) points to seven clinical priority areas, to reward practices for delivering a range of new services for patients.
They also agreed changes to prevalence arrangements, which reflect the number of patients in a practice on each disease register and are used to calculate QOF payments.
Changes to points
The reallocation of 72 points across the seven clinical priorities are:
- helping to prevent the development of cardiovascular disease in people diagnosed with high blood pressure - 13 points
- improving advice and choice on contraceptive methods - 10 points
- a new indicator for depression to reduce early cessation of treatment - 20 points
- improving indicators for chronic kidney disease (11 points), diabetes (7 points) and chronic lung disease (2 points) - totalling 20 points
- improving drug treatment for people with heart failure - 9 points
We have produced more detailed guidance on these changes for primary care trusts and practices.
Changes to prevalence
Also in 2009/10, the following changes to prevalance arrangements were agreed and are effective from 1 April 2009:
- discontinue the square rooting element of current arrangements
- use true prevalence to determine QOF payments
Although the overall impact is expected to be broadly cash neutral, a small number of practices may experience a significant reduction in their current QOF income following changes to how we calculate QOF payments. The health departments issued the following guidance to trusts which was summarised in a joint letter to PCT chief executives, from NHS Employers and the GPC:
- Primary care organisations should work with practices that identify themselves as experiencing a significant loss in their income, to understand the impact of the new arrangements on their current service provision.
- Primary care organisations may also want to use this opportunity to consider the local health needs of populations and, working with local medical committees and practices, to identify whether new services or improvements in care should be commissioned to address these local needs.