As part of the 2013/14 GMS contract changes, the Department of Health (DH) implemented a number of changes to the QOF effective from 1 April 2013.
The key changes were:
- The implementation of NICE recommended replacements, new indicators and retirements:
- the introduction of 12 new NICE recommended clinical indicators, including one new clinical area for rheumatoid arthritis
- the delayed introduction to 2014/15 of two new NICE recommended clinical indicators for cardiac and pulmonary rehabilitation (the points originally identified for these two indicators would be added to HYP003, HYP004 and HYP005 as a result of their delayed introduction)
- the replacement of seven indicators with six NICE recommended indicators, focusing on depression, cancer, cardiovascular disease - primary prevention, blood pressure recording and smoking
- the retirement of eight indicators (CHD10, BP4, DM2, DM10, DM22, DEP1, CKD2 and EP6) releasing 34 points to fund new and replacement indicators.
- The introduction of a new public health domain.
- The removal of the organisational domain indicators not retained in the quality and productivity domain or moved into the public health domain. This released 137.5 points to fund the NICE recommended indicators and four new enhanced services (ES).
- An increase in thresholds for all existing indicators, in line with the 75th centile of achievement phased in over two years. For 2013/14, this applied to 20 indicators and the remaining indicators from 2014/15. From 2015/16 thresholds will change on an annual basis in relation to practice achievement.
- The thresholds for the two new indicators on increasing physical activity for patients with hypertension (HYP004 and HYP005) would be phased in over two years.
- The removal of the current end-of-year overlap for most indicators by changing the indicator timeframe from 15 to 12 months or 27 to 24 months (this included changing the time period for general exceptions within the Business Rules).
- Amendments to indicator wording for a number of indicators (see detailed changes spreadsheet for full details).
- Updating the Contractor Population Index (CPI) in order to reform the list size weighting.
In addition to the key changes listed above, a number of changes were made to the QOF guidance.
- References to PCT's and PCO's have been removed and updated to reflect the NHS Commissioning Board's (known as NHS England from 1 April 2013) role.
- Indicator wording was updated to include important information within the Business Rules or guidance i.e. specifying age ranges and timeframes or whether the care described should be delivered in the context of a face-to-face consultation.
- The reordering and renumbering of all indicators to improve the flow of the document and to reflect that a number of changes were made to indicator wording.
The detailed QOF guidance is available to download here.
As there were also a number of miscellaneous changes to the QOF for 2013/14, a spreadsheet detailing the updated indicator IDs, changes to indicator wording and timeframe is available to download for information.
NICE menu of recommended changes to the QOF
On 1 August 2012 the National Institute of Health and Clinical Excellence (NICE) published the 2013/14 menu of QOF recommendations.
For full details of the recommendations made by NICE along with any relevant supporting documents, please see the NICE website