Latest QOF report shows increase in general practice achievement
NHS Digital has published its 2017–18 Quality and Outcomes Framework (QOF) report on the prevalence of conditions managed in primary care in England and the achievements of general practices. The report uses data derived from information provided voluntarily by 94.8% of general practices (7100 in total) in England.
The report identifies how the prevalence of 21 conditions (including asthma, hypertension, diabetes, depression, coronary heart disease and obesity) has changed over the last year. The conditions were selected because the responsibility of ongoing management rests principally with the primary care team, because of the health benefits likely to result from improved care, and because the disease area is considered a high priority. The latest QOF shows highest prevalence rates for hypertension (13.9%), depression (9.9%) and obesity (9.8%). The condition with the greatest increase in prevalence compared with the 2016–17 report is depression, which increased by 0.9 percentage points, while hypertension and obesity rates have remained relatively stable over the past year (each increasing by 0.1 percentage points).
The QOF also provides information on the achievement of general practices overall in relation to 25 indicators, and QOF payments are calculated from the achievement scores allocated to each indicator. A total of 888 practices (12.5%) attained maximum achievement scores in 2017–18; this compares with 883 practices (11.9%) in 2016–17. The average achievement score in 2017–18 was 537.5 out of a maximum of 559 points. The value of a QOF point increased by 3.6% between 2016–17 and 2017–18, and is now £171.20.
New QOF indicators
Meanwhile, NICE has developed nine new indicators for general practice suitable for inclusion in the QOF menu, following a consultation over the summer. Eight of the indicators focus on diabetes, using risk stratification measures such as frailty in order for general practices to identify which people will benefit from tightest glycaemic control and to decrease the risk of treatment-related harm. The ninth indicator relates to the establishment of a register of patients with a history of atrial fibrillation, as these people continue to benefit from anticoagulation therapy to reduce their risk of stroke. The new indicators will be referenced in the development of the 2019–20 QOF, but the content is decided through negation between NHS England and the General Practitioners Committee, and NICE is not involved in these negotiations.