Health minister defends practices on exception reporting

Fraudulent use of quality framework (QOF) exception reporting is the 'exception' rather than the norm, according to health minister Ann Keen.

Speaking in Parliament last week, she said: ‘The overall exception rate for England reduced from 5.83% in 2006/7 to 5.26% in 2007/8. Independent research shows that practices in deprived areas are slightly more likely to exception-report patients than practices in affluent areas - I believe that the difference is less than 1%.

‘The research concludes that GPs in deprived areas achieved high QOF scores without high rates of exception reporting, and the differences in scores between affluent and deprived areas are small and of relatively little clinical significance.

‘Our proposals for a new independent and transparent process for reviewing QOF indicators are intended to build on the QOF’s ability to help reduce health inequalities and respond to the needs of our diverse society.

‘There is evidence from research that some practices, whether in deprived or more affluent areas, may be using exception reporting inappropriately. Manipulating QOF data in order to increase rewards without delivering the required level of quality for patients is clearly unacceptable, and also unfair on the majority of practices, which comply with QOF requirements.

‘PCTs are responsible in England for verifying evidence for QOF achievement. They should analyse exception rates as part of this, investigating any outliers, correcting QOF payments where necessary and taking action if they uncover any actual fraud. I stress that fraud is the exception. We have provided guidance and training for PCTs on examining exception reporting as part of QOF assessment and verification.’

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