How we stay in control of our QOF work
Dr Gavin Jamie explains how his practice manages admin for the Quality and Outcomes Framework
Name Whalebridge Practice, Swindon, Wiltshire (GPcontract.co.uk profile)
List size 9,700
Full-time equivalent GPs Four, with one part-time partner and three full-time, one of whom is retiring at Christmas
We try to do as much of QOF during routine care as we can
There are two sides to QOF: you have to do the work in the first place, and then you have to code it correctly. We try to focus most of our QOF activity during routine visits. For instance, when patients come in for a blood pressure check, if there is anything else due we will try to do that at the same time. Having said that, we also have a COPD clinic and we do have diabetes and asthma reviews run by nurses who are using templates to assess patients. However, the GPs do most of the reviews because they can look at more than one condition at a time.
Good communication within the team is key to achievement
The partners spend a bit of time discussing where we are and if there are any areas that we are slipping back on, or that aren’t being coded, we will make people aware of that. Identifying these issues and communicating them to the team is so much simpler than chasing everything up at the end of the year.
A recent IT update has helped us
Earlier this year, we switched to EMIS Web from EMIS PCS and we have found things simpler since the change. QOF reminders are better and we feel we are slightly ahead doing that. Our previous system wasn’t going to keep running after April so we felt we had to make the jump.
We’ve always been a GP-heavy team
We have four partners at the moment and have had a couple of part-time salaried GPs who were doing QOF alongside other work. We also have one nurse prescriber, although she does not do things that doctors would otherwise do, and a couple of other nurses. We would like to recruit as just getting doctors face-to-face with patients in a room is a challenge now, but with our current financial situation, we have to provide access with the people we’ve got.
We rarely use locums
Using partners and small number of sessional GPs is our way of keeping on top of the job as we go along. Some locums are great, but we have our way of doing things, so there is not necessarily the greatest value in having someone nipping in and out. Certainly, in terms of ticking QOF boxes, the partners are better at doing that than GPs we need to brief each time.
For diseases like diabetes, per-patient QOF funding is actually decreasing
The major bulk of the diabetes workload for us is managing blood sugar, cholesterol and blood pressure in our patients – we’re seeing more and more people with the disease. Our own data show that the number of patients diagnosed with diabetes at our practice means prevalence is rising faster than the UK average. So as the UK prevalence goes up, the cash per patient at a practice with a diabetes profile like ours actually goes down.