As part of the 2012/13 GMS contract changes, NHS Employers and the General Practitioners Committee (GPC) agreed a number of changes to the QOF effective from 1 April 2012.
The key changes were:
- 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 attendances
- amendments to indicator wording for CHD9, CHD10, CHD14, STROKE12, DM26, DM27, DM28 and DEM3
- inclusion of telephone reviews for Epilepsy 6.
The detailed QOF guidance is available to download here.
Quality and productivity indicators
The six quality and productivity (QP) indicators covering outpatient referrals and emergency admissions were agreed for a further year. Three new QP indicators on accident and emergency (A&E) attendances were introduced for one year and were 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 February 2012, NHS Employers and the GPC published joint supplementary guidance and FAQs for the 2012/13 QP indicators. This guidance applied across England, Northern Ireland, Scotland and Wales. It was intended to assist Primary Care Organisations (PCOs) and practices in understanding and working through the continued and new QP indicators
The separately published Quality and Productivity Accident and Emergency guidance, published in late 2011, was incorporated in the national 2012/13 QOF guidance and is no longer available.
In addition to the above, a number of other changes were 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 Smoking 5) – reduced by five points to 25 points, and
- Smoking4 (now Smoking 6) – reduced by five points to 25 points
- A number of threshold changes as follows:
- raising all lower thresholds for indicators currently 40-90 per cent to 50-90 per cent
- raising all lower thresholds for indicators currently with an upper threshold between 70-85 per cent to 45 per cent
- a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31 and COPD10
- lower and upper threshold changes for BP5, MH10 and DEM2.
- ASTHMA 3 was renumbered to ASTHMA 10 following a change to the business rules to include a new exception cluster.
- DEP1 and DEP4 were renumbered to DEP6 and DEP7 respectively following a change to the prevalence calculation to apply to all new diagnosis of depression from April 2006.
- MH14 was renumbered to MH19 following a change to the business rules to include an exclusion cluster for patients already diagnosed with CVD.
- Records 23 was moved into the clinical domain and the supporting business rules were amended. This indicator was renumbered to Smoking7.
- Education 1 was renumbered to Education 11 due to change to the indicator wording.
Please see Summary of 2012/13 QOF indicator changes - updated February 2012 for a breakdown of indicator wording, points and thresholds.
Error in 12/13 QOF Guidance for Osteoporosis indicator 1
NHS Employers and the General Practitioners Committee of the BMA were made aware of an error in the 2012/13 QOF guidance for indicator OST1. The sentence 'the DXA scan codes will only be those that indicate a positive result of osteoporosis, and T score codes will not be included' under the reporting and verification section was incorrect(see page 140 of the 2012/13 QOF guidance) and contradicted the business rules. It should have read 'The DXA scan codes will only be those that indicate a positive result of osteoporosis'. This correction did not impact the supporting business rules which were correct. A revised version of the 2012/13 guidance was not issued.
QOF frequently asked questions
NHS Employers and the GPC published an updated set of the joint QOF frequently asked questions (FAQs) for use by primary care organisations and general practice. These FAQs apply across all four countries and cover a number of historical issues and commonly asked questions.
The QOF queries process is clearly outlined in this FAQs document and we ask that this document is consulted before any queries are raised with the relevant parties.
QOF business rules
For details on the business rules process and link to the updated rule sets, please see the Developing the QOF Business Rules page.
NICE menu of recommended changes to the Quality and Outcomes Framework
On 1 August 2011 the National Institute of Health and Clinical Excellence (NICE) published the 2012/13 menu of QOF recommendations.
For full details of the recommendations made by NICE along with any relevant supporting documents, please see the NICE website