Last review date 31/05/2023
1. QOF Calculations
What is the 'Contractor Population Index' (CPI) and how does it work?
The CPI is calculated by dividing the practice list size by an NHS agreed 'average list size'. In 2023/24 the agreed average list size is 9639. Each year this agreed list size is increased.
- Example practice;
With 15,326 patients the CPI would be 15326 divided by 9639 = 1.59. This CPI of 1.59 is then used in the practice final achieved pounds calculation
- Example practice;
For achieved QOF points a total of £100,000.00 x CPI 1.59 = £159,000.00
The greater your practice list size the greater your CPI will be which will have a positive effect on your QOF payment.
By increasing your QOF register sizes (prevalence) you can make a big difference to the value of your achieved QOF points. The value of the QOF point for 2023/24 is £213.43.
You can view your practice prevalence by going to 'Reporting > QOF Indicators > National Prevalence'
As you can see in this example above Dementia is much higher than the national average 222.7% which means the QOF point value would be around £450. Where the prevalence is below the national average such as Cardiovascular Disease
Primary Prevention which in this example is only 10.9% of the national average the value of the QOF point drops to around £23
So this screen is a good visual aid to check that your practice is on track to match if not better the national average prevalence.
2. QOF Alerts
To ensure that all staff have access to the correct and most up to date QOF templates it is essential that the QOF alerts are configured correctly. This is detailed in the setup article for when you first go live with Ardens. If not then there is a risk that staff will use the wrong templates and potentially the wrong codes which may affect QOF achievements.
Many practices find it useful to set the QOF alerts to 'End of Year'. This can be configured by going to Setup > Users & Policy > Organisation Preferences > QOF and at the top of the screen click on 'Use 'End of Financial Year' figures for QOF Alerts.
NB: Always ensure that old templates are deactivated, please see housekeeping support article to find out more about this.
3. Automatic Episodicity
This can be very helpful for QOF registers that are specifically looking for a new episode of a diagnosis such as cancer. Go to 'Setup > Users & Policy > Organisational Preferences > Clinical Coding'. From here you can add a diagnosis cluster or remove one.
The next time a diagnosis is recorded the clinician will be prompted to record it as a new episode.
NB: This screen should be reviewed as new versions of QOF are released. In the example above you can see one of the clusters than has been used has been retired.
4. Indicator Values
This is another useful screen that can be used to target work effort with the most QOF value. Columns can be sorted by clicking on the column header to order by highest value to lowest
Go to ‘Reporting > QOF Indicators > Indicator Values’
5. Target Patients
This screen can be useful towards the end of the QOF year again to target work effort to most QOF value.
Go to ‘Reporting > QOF Indicators > Target Patients’
6. Validating Registers and Increasing Prevalence
Under the terms of the GMS contract, It is a contractual requirement to validate your QOF registers
“While it is noted that these may not be completely accurate, it is the responsibility of the contractor to demonstrate that it has systems in place to maintain a high-quality register and this may be verified by commissioners by comparing the reported prevalence with the expected prevalence and ask contractors to explain any reasons for variations”
The cut-off date for prevalence data extractions or 'National Prevalence Day' used to be 14th February each year but is now in line with the QOF year and always on 31st March.
To help practices we have a set of QOF reports which can be found at 'Reporting > Clinical Reporting > Ardens > Contracts | 2023 24 | QOF > Case Finders’. A separate 'QOF Health Check - Case Finders' support article explains how to use these reports
Caution: Some registers can create an additional amount of workload for the practice in a tight time frame and could have a negative impact on other indicators, such as;
- Depression diagnosis – review 10-56 days later
- Cancer diagnosis – review within 6 months
- Dementia diagnosis – bloods 12 months before to 6 months after
If patients are not already on the register you may have already completed some of the requirements but because no diagnosis has been recorded not getting paid. There is usually a greater income benefit to increasing prevalence.
7. QOF Timeline
There are many occasions when you struggle to work out why a patient has a QOF alert showing on their home screen.
One tool that can be useful is the QOF Timeline. To access this you will need to add it to your clinical tree. This article explains how to configure the clinical tree, this is what you are looking for in the search.
Once you have it in the clinical tree you can click on it to show achievements in green, work to do in pink and exempt items in grey. You can right click on any outstanding items and you will be offered to record an achievement specific to that indicator. Unlike the QOF alerts which dont disappear until the reports have rerun overnight, this data is up to date.
8. Accessing QOF Templates
From the condition template
Clicking on the various icons below the patients demographics box will open the condition templates rather than the QOF specific templates. The data entry fields marked with a red star are the QOF requirements. From each of the condition templates there is a link to the QOF template which is consistently a red star symbol in the bottom right corner.
From the QOF alerts
The QOF alerts on the patient home screen will only take you to the Ardens QOF templates if your practice has setup the QOF alerts by following the instructions in step 5 here. Exception coding is available on all QOF templates - More information about exempting patients can be found here.
From the F12 Launcher
If you have added any QOF templates to the F12 launcher you can access them using this method. This is useful for clinicians that deal with specific LTCs and carry out QOF reviews.