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COPD and smoking indicators among clinical QOF changes

By Lilian Anekwe

The BMA and NHS Employers today announced the changes to the Quality and Outcomes Framework, which will come into effect from next Tuesday.

The changes include a new indicator for COPD and new patient groups added to the QOF indicator for smoking.

Today's announcement also confirms controversial moves to raid 38.5 QOF points from existing domains to cover access and patient experience, making a total of 58.5 access points

The exact wording is yet to be agreed, but the QOF payment for the new points will be dependent on the results of access questions in the new patient experience survey on 48 hour access and advanced booking.

Dr Laurence Buckman, chair of the GPC said: 'There will also be a few evidence-based changes to the QOF such as improvements to the smoking indicator and a new COPD indicator to bring it in line with NICE guidance and taking account of spirometry readings. All the evidence-based changes are detailed in the new GPC guidance note.'

A new indicator is included for COPD , which will mean the QOF taking into account the percentage of all patients with COPD diagnosed after April 1st 2008 in whom the diagnosis has been confirmed by post bronchodilator spirometry.

Stroke, diabetes, palliative care, CKD, atrial fibrillation and smoking have all had minor changes made to their QOF indicators, ‘to ensure that the QOF stays in line with new clinical evidence and the evolving nature and work of general practice.'

In the smoking indicator, GPs will be scored on new patient groups including those with CKD, schizophrenia and bipolar affective disorder or other psychoses.

The thresholds for payment within the QOF remain unchanged.

Dr Adrian Jacobs, joint-chair of the NHS Employers QOF review team, told Pulse the changes would not have major workload implications for GPs.

He said: ‘The focus of the changes we have made has been on releasing QOF points to re-invest in other parts of the contract and in making amendments to existing indicators to ensure they are in line with the latest clinical evidence and the work of general practice. The continuing success of QOF depends on it being able to adapt to reflect developments in patient care and changes in the delivery of services.

‘We are still discussing the full details of how the indicators will work in practice with the GPC and we will be publishing amendments to the Statement of Financial Entitlements shortly.'

COPD: among clinical changes to QOF COPD: among clinical changes to QOF

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