Many practices have been affected this year by the changes to the QOF business rules for Asthma reviews. 


Since 1st April 2020 the requirements for reviews changed significantly. As the business rules were not released until very late in the year the Ardens QOF templates were updated with what we considered would be included in the changes. QOF in SystmOne was not updated to the latest business rules until September. The Ardens QOF templates were all double checked at that point with some adjustments made in coding to match the released business rules. 


Since the September update practices who have been reviewing patients prior to that have noticed their achievement percentages have dropped massively. 


Related article QOF 2020-21


V45 business rules for Asthma Reviews AST007

Problem

These must all be recorded on the same date, if any item is missing or recorded on a different date the indicator will not be achieved;

  • A review code
  • Asthma control test score (replaced the 3 RCP questions previously used)
  • Number of exacerbations (even if zero) 
  • Inhaler technique (mentioned in business rules but not included in reporting) 
  • Care plan (some care plan codes that were used prior to the update are no longer recognised by QOF, see below)


Resolution

Go to 'Reporting > Clinical Reporting > Contracts I Current Financial Year I QOF > Missed income I Indicators' and find this 'AST007 | Asthma review + non QOF codes used since 1/4/20 (amend care plan code to XaYZB)'

1 Care plan codes 

1.1 - Identify affected patients 

Run 'AST007 | Asthma review + non QOF codes used since 1/4/20 (amend care plan code to XaYZB)', right click and select breakdown results by 'Coded Entries > Read code' and refresh


This report is looking for either of these codes which were QOF codes pre v45; 

  • Asthma management plan given (663U.)
  • Asthma self-management plan agreed (XaYb8)

Make a note of which codes you find.  These can be bulk amended to a new QOF code whilst maintaining the original dates recorded. 


1.2 Code conversion  

Go to 'Setup >Bulk Operations > Read Code Replacement'  

Step 1 - Read code to be replaced 

Search for first code and select 'Replace diagnoses between two dates and enter from 01/04/2020 to today and click on continue 


Step 2 - patients

This screen will show the patients that have that code recorded since 1/04/2020

Step 3 - Replacement 

Search and enter 'Asthma self-management plan review XaYZB' and click 'Continue' 

Step 4 - Confirmation

This is the final stage and once you are happy you have got it all correct click on 'Run'. The conversion will run overnight. 


NB: The QOF results may not show any improvement until another night has passed and the QOF reports have re-run again. 

Repeat steps 1-4 for each old care plan code found in the report. 


2. All items recorded on the same date

Go to 'Reporting > Clinical Reporting > Contracts I Current Financial Year I QOF > Missed income I Indicators' and find  'AST007 | Asthma review since 1/4/20 + missing data on same date (use Asthma QOF report output to view data and dates)'


2.1 - Identify affected patients 

Run 'AST007 | Asthma review since 1/4/20 + missing data on same date (use Asthma QOF report output to view data and dates)', right click and show patients. 


'Select Output' 

'Pre-defined report output > Asthma QOF' and click 'Ok'

You should then see a list of all review activities where one or more element are either not recorded or not on the same date.