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Average QOF performance falls for the first time in three years, official figures reveal



Average QOF-points achieved by practices in England decreased in 2012/13 in comparison with the previous year, but more practices achieved the maximum score of 1,000 points, official figures today have revealed.

The average number of points achieved by practices decreased by 0.8 percentage points to 96.1%, mainly driven by a marked decline in the number of practices achieving maximum points in the clinical domain, according to data published today by the Health and Care Information Centre. This bucked the trend of increased achievement over the past three years.

However, the percentage of practices achieving maximum points increased from 2.4% to 3.7% in 2012/13.

The HSCIC suggested that the decrease in the average number of points may have been influenced by the addition of new disease areas (PAD and osteoporosis) to the clinical domain ahead of 2012/13.

Looking at the clinical domain in isolation, the number of practices achieving the maximum score dropped markedly, by 6.5 percentage points, from the previous year’s 10.7% of practices to just 4.2%.

In 2011/12, the number of practices achieving the top score overall more than doubled, with average performance also rising.

Overall exception reporting fell last year by 1.5 percentage point to 4.1%, with the report authors putting this down to changes to the smoking indicators. The new Smoking 07 and Smoking 08 indicators include large numbers of patients in their respective denominators, and this has the impact of reducing the overall exception rate as the overall denominator is much higher, they said.

Hypertension (13.7%, 7.7m patients) and asthma (6%, 3.4m patients) remained the two conditions reporting the highest prevalence rates for conditions covering all ages. These two conditions have consistently had the highest rates since introduction of QOF measures in 2004/05. Meanwhile, QOF reported prevalence for depression reduced considerably compared with 2011/12, attributed to a change in the business rules for the depression register.

Previously all patients with a record of unresolved depression at any point in their GP patient record were included on the register. As of April 2012, the register rules were changed to only include patients with a record of unresolved depression since April 2006, resulting in fewer patients on practice depression registers. Obesity (10.7%, 4.9m patients 16 and over) and diabetes (6%, 2.7m patients 17 and over) were the conditions with the highest recorded prevalence rates for age-specific indicators.

GPC deputy chair Dr Richard Vautrey said about the figures: ‘This suggests that practices are continuing to work hard, improving their systems for dealing with QOF and providing an excellent level of care to their patients. It’s remarkable that practices have done so well with the heavy workload pressures that they are under. There are a small number of indicators that are particularly difficult to achieve and I would suspect that the very small decrease in achievement is related to them.’

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