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Exception reporting rates at lowest since QOF began

By Lilian Anekwe

Exception reporting rates in England have fallen again, to their lowest level since the Quality and Outcomes Framework was drafted in 2004.

But the analysis, published by the NHS Information Centre, notes that ‘the exception rate for indicators that measure an outcome was higher than for indictors that measure a process.'

Both current and shadow health ministers have spoken of their desire to reshape the QOF so that it includes a higher proportion of outcome measures.

In 2008/9 exception reporting for all outcome indicators combined was 6.9%, compared to 1.7% for process indicators – reflecting their more difficult nature to achieve.

‘The highest exception rates relate to indicators that measure an outcome or action in respect of a diagnosis', the report states. ‘The highest exception rate, 25.4%, was for COPD 12 indicator, which is the percentage of all patients with COPD diagnosed after 1 April 2008 in whom the diagnosis has been confirmed by post bronchodilator spirometry.

7.2% of all intermediate outcomes were excepted for in 2008/9, and 6.3% of objective outcomes were excepted.

But the overall exception rate across all indicators fell to 4.87%, down from last year's level of 5.26%.

The average exception reporting rate calculated for each of the 8,215 practice in England was 4.85%, down from 5.26% in 2007/8.

This highest exception reporting rate was recorded for indicators in the mental health domain, at 12.6%, and COPD, at 10.2%.

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