Whilst QOF point achievement is protected for most indicators this year, QOF income remains list-size and prevalence weighted (NHS-E guidance, page 4). This is important for GP practices, but also matters to PCNs & CCGs as these organisations require accurate prevalence data for planning purposes (e.g. COVID-19 vaccine prioritisation).
Ardens Resources to Improve Prevalence
We have released a suite of searches ("Ardens Case Finders") that can be used to identify coding errors affecting reported chronic disease prevalence in individual GP practices. These searches replace the annual "QOF Data Validation Report" that practices may have received from Ardens in the past and have the benefit that they can be run at any time to review practice data quality.
The searches can be downloaded now by subscribers via the Ardens Portal. The deadline to complete this work is 31st March (this is when prevalence data is extracted from GP practices), although we recommend doing this much sooner. Correcting these coding errors can generate additional income of up to £500/1,000 patients.
We have produced detailed instructions that explain how to use these searches and we recommend that you read these before undertaking any re-coding work.
Ardens Manager - National Contract Dashboards
Case Finder data can be uploaded to Ardens Manager in areas subscribing to the National Contract Dashboards to help monitor and track improvement in data quality.
Technical Explanation (for those that are interested)
How is prevalence linked to QOF income?
QOF income in any financial year is calculated using 3 variables:
- QOF points achieved - 310 QOF points (out of 567) have been protected at 2019/20 achievement levels this year. The value of a QOF point for 2020/21 is £194.83.
- Contractor Population Index (CPI) - this is your practice list size divided by the "national average list-size" which changes annually (for 2020/21 it is 8,799 patients)
For example if your list size is 16,000 patients then your CPI is 16,000 / 8,799 = 1.82.
- Adjusted Practice Disease Factor (APDF) - this is your practice disease prevalence for a particular chronic disease divided by the national average disease prevalence. You can view your practice data from last year using NHS Digital's online database (although I find www.gpcontract.co.uk easier to use).
For example the national average prevalence of AF for 2019/20 is 2.05%. If your practice prevalence is 3.05% then your APDF for AF will be 3.05/2.05 = 1.49.
All 3 of the above variables influence what payment is made for each QOF domain:
QOF income = Points Achieved x £194.83 x CPI x APDF
So, using the above AF example in a 16,000 patient practice with all 29 points achieved:
QOF income for AF = 29 x £194.83 x 1.82 x 1.49 = £15,312
Please note that no-one has access to 2020/21 prevalence data as it is not extracted until March 31st 2021. The above calculations will therefore only be approximate as we have to use 2019/20 national prevalence data.