Quality and Outcomes Framework Assessor Training

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Quality and Outcomes Framework Assessor Training

• QOF Basics
• Domains, Evidence and Local Frameworks

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Plan!

• Overview of QOF
• Domains
• QMAS
• Sources of Evidence
• Developing Local Frameworks

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QOF Improvement Cycle
Planning
QOF IMPROVEMENT CYCLE
Action
Learning
Review
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QOF Activities for 2004/5
Feb 2004 Agree aspiration
April 2005 Achievement payments made
Apr 2004 Pay QPrep and QuIP DES
Oct 04 Jan 05 Annual review visits take place
QOF 2004/5
April 2004 QOF goes live
April 2004 DH guidance on review visits
August 2004 QMAS system goes live provides
monthly feedback
End April 2004 Monthly aspiration payments
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Quality and Outcomes Framework (QOF)

• New primary care tool and major source of new
  funding
• Four domains - Clinical, organisational, patient
  experience and additional services
• Focused on the improvement of quality and
  outcomes of patient health
• Evidence based indicators

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Structure of the QOF

• 1050 points available
• 75 per point 04/05
• 120 per point 05/06
• 4 Domains
• Clinical
• Organisational
• Patient Experience
• Additional Services

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QOF Domains

• Clinical domain
• 10 disease areas
• 550 points
• Organisational domain
• 5 areas
• 184 points
• Additional Services domain
• 4 areas
• 36 points

• Patient Experience domain
• 2 areas
• 100 points
• Holistic Care, Quality Practice and Access Bonus
  Points
• Total 180 points

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Clinical Domain

• The 76 Clinical Indicators split into 3 types
• Structure e.g is a disease register in place
• Process e.g is the indicator being measured and
  an appropriate intervention being made for what
  of relevant population
• Outcome how well is the condition being
  controlled across what of the population

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Payments

• New money in primary care
• Aspiration payments (monthly from April 2004)
• Achievement (lump sum in April 2005)
• s per point
• 2004/05 75
• 2005/06 120
• List size
• Prevalence
• Pre-payment verification

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IMT and Data Flows

• Practices require an RFA99 compliant clinical
  system
• Reports from QMAS
• monthly to PCTs, at least monthly to practices
• QMAS reports will, in time, have comparative data
  on achievement and trends
• local and national
• Impact of Freedom of Information Act
• January 2005

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Quality Management Analysis System
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Principles

• Not patient based data
• Pre-populated with IAU data
• Single national system ensures
• High trust and transparent
• Changes to QOF scheme can be supported
• Payments calculated on a consistent basis for all
  practices
• Single feed to NHAIS payment system
• Practice and PCT access to same information based
  on access rights
• Reduced dependence on individual suppliers
• Value for money

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GP Practice
PCT
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Evidence

• Information the practice must submit in advance
  of the visit together with guidance for PCO
  assessors
• Grades of Evidence
• Indicator
• Written Evidence
• Assessment Visit
• Assessors Guidance

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Local Frameworks

• Who can develop local QOFs?
• PMS
• APMS
• PCTMS
• Local variations must have comparable frameworks
• Must be points based and add up to 1050

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Continued

• Local QOF must be agreed by Director of Public
  Health or another suitable person
• Equally, should be similar reward for similar
  effort between national QOF and locally agreed
  variants
• All practices participating in a QOF should have
  a QOF assessment visit

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Summary

• QOF will drive local quality improvements in
  primary care
• Lay assessors will bring objectivity and patient
  focus to visits
• Local intelligence important to know (K2)
• Part of a world first!