QOF localised in contract shakeup

The QOF will reward practices for performance on a local basis for the first time under new quality and productivity indicators detailed on Friday.

The new QOF domain, worth 96.5 points, is split between improving efficiencies in prescribing, referrals and emergency admissions. The changes came into effect from 1 April.

Click here for full details of the QOF indicator changes

For prescribing indicators, both the specific targets and the achievement threshold required for payment will be locally determined between practices and the PCO.

It means targets for improvements in prescribing behaviour, and ease of achievement, could be set at vastly different levels between neighbouring areas.

Practices will be paid to internally review practice prescribing to assess clinical and cost effectiveness, agree three areas for improvement with the local PCO.

Practices will then need to conduct an external peer review of prescribing with local group of practices, and agree on final plans for improvements that are then shared with the PCO.

Points are awarded on achievement against these plans between January and March 2012.

Practices should aim to match the 75th centile of national performance for the previous quarter of the year – from October to December – to earn full points.

This upper threshold can be lowered in negotiations depending on local circumstance. Points are awarded on a sliding scale for the 20 centile points below the agreed upper threshold.

Under indicators for referrals and emergency admissions, practices will need to review internal data and participate in an external review with a group of local practices.

They must design goals for improving referrals figures in a similar way to the prescribing indicators, and then deliver on these targets.

GPC deputy chairman Dr Richard Vautrey said the arrangements were a ‘test bed’ for new ideas. Care pathways that can demonstrate benefits to patients could be rolled out nationally.

‘The NHS needs to be better at learning where best practice has worked,’ he said.

Dr Vautrey added that the indicators will foster better links between local practices.

GPC deputy chairman Dr Richard Vautrey said the arrangements were a ‘test bed’ for new ideas. Care pathways that can demonstrate benefits to patients could be rolled out nationally. ‘The NHS needs to be better at learning where best practice has worked,’ he said.

Dr Vautrey added that the indicators will foster better links between local practices.

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