There are several QOF indicators which have a time limitation for achievement. If this time period is missed there is nothing that can be done to gain the QOF points for those patients.
These indicators are as follows.
- Asthma (AST011) - Spirometry and one other objective test between 3 months before or 6 months after diagnosis (if diagnosis on or after 1 April 2023) OR within 6 months of registration (If newly registered with a diagnosis on or after 1 April 2023 but no record of objective tests being performed at the date of registration).
- Cancer (CAN004) - Cancer care review within 12 months of diagnosis.
- Cancer (CAN005) - Support discussion within 3 months of diagnosis.
- COPD (COPD014) - Offer of referral to pulmonary rehabilitation if MRC scale >=3 (excluding those who have previously attended a pulmonary rehabilitation programme).
- Depression (DEP004) - Depression review within 10-56 days after diagnosis.
- Diabetes (DM014) - Structured education referral within 9 months of diagnosis.
- Heart Failure (HF008) - Echo or specialist assessment to confirm a diagnosis in the 6 months before diagnosis (if diagnosis on or after 1 April 2023) OR within 6 months of registration (If newly registered with a diagnosis on or after 1 April 2023 but no record of an echocardiogram or a specialist assessment at the date of registration).
The clinical reports which can be used to assist you with these can be found in the 'Contracts I 2023 24 I QOF>Time Sensitive' folder.
Reports with a time left period will show patients where there is still time left to achieve the work and are split into different periods depending on the indicator rules.
Time-expired reports will show patients who have missed the time period required for the work to be completed in.
Please note the following -
- AST011 - As this indicator looks at a time period before and after diagnosis in addition to a time period after registration (if newly registered) the time left reports only take into account time remaining after diagnosis/registration. The time-expired report will take into account time before and after.
- HF008 - As this indicator only looks for a time period before diagnosis in addition to a time period after registration (if newly registered) the time left reports only take into account time remaining after registration. The time-expired report will take into account time before and after.
- DEP004- The Too early report will show patients who have been diagnosed in the last 0-10 days so it is currently too early for them to have a depression review.
- COPD014 - This indicator requires an offer of pulmonary rehabilitation and includes the following two codes. The business rules do not include a declined code. If a patient has a declined code you can consider adding the offered code instead (Assuming if they have declined a referral they must have been offered one).
- Time Expired - Although these reports show patients who have missed the time frame for the work to be completed it may still be worth checking these records in case the work has been done but not coded or coded with a non-QOF code. You may also still want to 'achieve' these patients from a patient care perspective.
- Exceptions - All reports remove patients with an exception (personalised care adjustment) recorded in line with the business rules for the indicator.
- Exclusions - Most QOF indicators automatically exclude patients who are registered or diagnosed in the last 3 months of the year. These reports will not remove these patients so they will be included unless the work has been done or an exception recorded (If the work is not done by the end of the year you will not be penalised from a QOF point of view).
- Appointments - None of the time-sensitive reports take into account whether a patient already has an appointment booked so you may want to check these patients before inviting/contacting them.
If needed, you can download the QOF Business Rules here.