A complete guide to QOF changes for 2009/10
Full details of changes to the QOF for 2009/10. Bookmark this page or print out the attached guide.
All of the new indicators detailed below will be reviewed prior to the start of 2011/12, in the light of changing priorities for health and healthcare.
Heart Failure (9 new points)
One new indicator (which moves the current HF DES for England into QOF):
• HF 4: The percentage of patients with a current diagnosis of heart failure due to LVD who are currently treated with an ACE inhibitor or Angiotensin Receptor Blocker, who are additionally treated with a beta-blocker licensed for heart failure, or recorded as intolerant to or having a contraindication to beta-blockers. (9 points; thresholds 40 – 60%)
Chronic Kidney Disease CKD (11 new points)
Five additional points will be allocated to existing indicator CKD 5:
• CKD 5: The percentage of patients on the CKD register with hypertension and proteinuria who are treated with an angiotensin converting enzyme inhibitor (ACE-1) or angiosten receptor blocker (ARB) (unless a contraindication or side effects are recorded). (5 additional points (so the indicator will be worth 9 points in total); thresholds 40 – 80%)
While this indicator will not change, the guidance will be changed.
One new indicator:
• CKD 6: The percentage of patients on the CKD register whose notes have a record of an albumin: creatinine ratio (or protein: creatinine ratio) value in the previous 15 months. (6 points; thresholds 40 – 80%)
The BMA and NHS Employers have confirmed that the majority of pathology laboratories in the UK have the capability and capacity to provide these tests.
Sexual Health - contraception (8 new points plus 2 points from current CON indicators, CON 1 and 2 which will be removed)
Three new indicators, as recommended in the 2008 expert panel report:
• SH 1: The practice can produce a register of women who have been prescribed any method of contraception at least once in the last year. (4 points)
• SH 3: The percentage of women prescribed an oral or patch contraceptive method in the last year who have received information from the practice about long acting reversible methods of contraception in the previous 15 months. (3 points; thresholds 40 – 90%)
• SH 4: The percentage of women prescribed emergency hormonal contraception at least once in the year by the practice who have received information from the practice about long acting reversible methods of contraception at the time of, or within one month of, the prescription. (3 points; thresholds 40 – 90%)
Anxiety and Depression (20 new points)
One new indicator:
• DEP 3: In those patients with a new diagnosis of depression and assessment of severity recorded between the preceding 1 April to 31 March, the percentage of patients who have had a further assessment of severity 5 – 12 weeks (inclusive) after the initial recording of the assessment of severity. Both assessments should be completed using an assessment tool validated for use in primary care. (20 points; thresholds 40 – 90%)
The BMA and NHS Employers also agreed that the depression section of the QOF guidance should be amended as follows:
Currently - "For the purposes of QOF measurement ‘at the outset of treatment' is defined as within one month of the initial diagnosis."
Revised - "is defined as within 28 days of the initial diagnosis."
Cardio Vascular Disease CVD – Primary Prevention (13 points)
Two new indicators:
• PP 1: In those patients with a new diagnosis of hypertension (excluding those with pre-existing CHD, diabetes, stroke and/or TIA) recorded between the preceding 1 April to 31 March: the percentage of patients who have had a face to face cardiovascular risk assessment at the outset of diagnosis using an agreed risk assessment treatment tool. (8 points; thresholds 40 – 70%)
For the purposes of QOF measurement, ‘at the outset of diagnosis' is defined as within three months of the initial diagnosis.
• PP 2: The percentage of people diagnosed with hypertension diagnosed after 1 April 2009 who are given lifestyle advice in the last 15 months for: increasing physical activity, smoking cessation, safe alcohol consumption and healthy diet. (5 points; thresholds 40 – 70%)
Diabetes (7 new points plus 28 current points)
There are currently two indicators with HbA1c targets (DM7 and DM 20) which have been subject to changes. There will also be a new indicator. The three indicators are as follows:
• DM 23: Replaces DM 20 (which has a HbA1C target of 7.5 or less and is worth 17 points)
The percentage of patients with diabetes in whom the last HbA1c is 7 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months. (17 points; thresholds 40 – 50%)
• DM 24: New
The percentage of patients with diabetes in whom the last HbA1c is 8 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months. (8 points; thresholds 40 – 70%)
•DM 25: Replaces DM 7 (which has a HbA1C target of 10 or less and is worth 11 points)
The percentage of patients with diabetes in whom the last HbA1c is 9 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months. (10 points: thresholds 40 – 90%)
COPD (2 new points)
One revised indicator:
• COPD 13: Replaces COPD 11
The percentage of patients with COPD who have had a review, undertaken by a healthcare professional, including an assessment of breathlessness using the MRC dyspnoea score in the preceding 15 months. (2 additional points so the indicator would be worth 9 points; thresholds 50 – 90%)
Click here to download QOF changes for 2009/10QOF changes Points removed