QOF exception reporting falls to its lowest rate

Greater stability of indicators may have helped to reduce exception reporting rates, experts say.

Professor Lester: annual checks
Professor Lester: annual checks

Exception reporting rates for England have fallen to the lowest level since the new GMS contract was introduced.

However, reporting rates for some indicators remain high and rates have risen for indicators changed in the 2008/9 QOF.

NHS Information Centre data show that the overall exception reporting rate for 2008/9 was 4.87 per cent. This represents a fall of 0.39 percentage points from the 2007/8 rate (5.26 per cent). Exception reporting rates varied from 0 to 59.52 per cent across indicators.

GPC negotiator Dr Chaand Nagpaul said the fall in reports was likely to be a result of improved recall: 'The reduction in exception reporting probably reflects GPs being far more focussed on following patients up and chasing non-attenders.'

Wiltshire GP Dr Gavin Jamie, a QOF statistics expert, believes that lower exception reporting is partly a result of recent stability of the framework.

'With stable indicators practices have well-practised systems for calling patients and patients are also used to the systems,' he said. 'Changing increases the exception rate.'

Professor Helen Lester, deputy director of the National Primary Care Research and Development Centre, said that most indicators with high exception rates made clinical sense, but that high reporting rates for the mental health review indicator (MH 9) remain a concern.

'An annual physical health check can help to pick problems up at an early stage and offer an opportunity for health prevention and promotion advice,' she said. 'Do one in seven people on the severe mental illness register really warrant exception reporting from this check?'

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