BMA and NHS England confirm QOF to restart in full from April

The BMA and NHS England have confirmed that the QOF will restart in full from April this year.

QOF restart planned (Photo: sturti/Getty Images)
QOF restart planned (Photo: sturti/Getty Images)

A letter sent to practices on 10 March from both organisations, alongside guidance for the framework for 2021/22, said that 'reinstating of QOF in full will support the recovery of long-term condition management'.

As a result of the pandemic, GP practices were provided with income protection on just over half of the QOF points available for 2020/21 in September last year.

In January the rest of the QOF was suspended as part of a number of measures aimed at freeing up practices to focus on the COVID-19 vaccination programme roll out. Practices will receive payments for 2020/21 in line with what they were paid in 2019/20.

QOF changes for 2021/22

At the start of this year, the BMA and NHS England announced there would only be minimal changes to the GP contract for 2021/22, to allow GPs and practice teams to remain focused on tackling the pandemic and the vaccination campaign.

This latest guidance confirms that most of the QOF for 2021/22 will be based on the indicators that were already in place for 2020/21. However a new vaccination and immunisation domain has been added to the framework as part of a wider overhaul of vaccination payments.

Four new immunisation indicators will replace the childhood immunisation DES to reward achievement and practices will be paid an item of service fee for each vaccine they administer from April onwards. Three indicators relate to childhood immunisations and the fourth is linked to uptake of the shingles vaccine.

The four QOF flu indicators will be retired from April, with targets instead being moved to the Investment and Impact Fund, which rewards PCNs for performance.

Meanwhile, three indicators focused on patients with severe mental illness have been reintroduced in a bid to improve uptake of physical health checks in this group of patients.

A new indicator requiring practices to inform patients diagnosed with cancer of the support they can expect from primary care has also been added and there are changes to the timeframe and requirements of the cancer review indicator.

The changes mean that from April the QOF will increase from 567 to 635 points. The letter also confirms that the value of a QOF point will be £201.16 in 2021/22 and the national average practice population figure used to calculate payments will be 9,085. There are no changes to payment thresholds for indicators.

Quality improvement domain

As previously announced, the quality improvement domain for 2021/22 will cover learning disabilities and early diagnosis of cancer - the two modules that were in the framework this year.

However, the BMA and NHS England have clarified that the modules will be 'repeated in their intended format', as was set out in original guidance for the QOF in 2020/21, rather than the amended version that was published in September 2020 to take account of the pandemic.

There will be 'some slight modifications' to the indicators in this domain to take to account of how the pandemic has affected patient care, the letter added.

GPs have been told that they can deliver patient reviews for QOF work remotely, where clinically appropriate. However face-to-face reviews are recommended for patients with dementia 'to allow primary care practitioners to fully assess the changing needs of the patient'.

'Practices should continue to apply their clinical judgement to the appropriate management of affected patients and the decision to provide a virtual or face-to-face review should be made on a patient-by- patient basis,' the letter said.

QOF points available for 2021/22

  • Clinical domain - 401 points
  • Public health domain - 160 points
  • Quality improvement domain - 74 points

Download the full QOF guidance for 2021/22

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