This site is intended for health professionals only

DH figures show exception reporting rise

By Lilian Anekwe

The number of patients exception-reported by GPs increased in 2009/10, figures published by the NHS Information Centre show.

The latest data for over 8,000 practices in England show the overall QOF exception reporting rate rose from an all-time low of 4.87% in 2008/9 to 5.14% in 2009/10.

The report from the NHS Information Centre, published this week, says ‘the increase is probably at least partly due to changes in the QOF, including the introduction of new clinical indicators, in 2009/10.’

The figures come after Pulse revealed earlier this month that the Government is considering scrapping the exception reporting system. Dr Colin Hunter, chair of the independent NICE QOF indicator advisory committee, told the RCGP conference in Harrogate that ‘there’s a very high-level discussion around exception reporting and whether it’s needed’

Four of the clinical domains in which new indicators were introduced in 2009/10 – COPD, depression, diabetes and heart failure – had increased exception reporting in 2009/10 compared to the previous year.

Exception reporting more than doubled from 8.01% to 17.23% in the heart failure domain, where a new indicator HF4 – the percentage of patients with a current diagnosis of heart failure due to left ventricular dysfunction who are currently treated with an ACE inhibitor or ARB and who are additionally treated with a beta-blocker – was introduced into the 2009/10 QOF. 37.81% of patients were exception reported from this indicator.

DEP03, a further assessment of severity in patients diagnosed with depression in the previous year given between 5-12 weeks after the initial diagnosis, had an exception reporting rate of 32.69%. Overall exception reporting within the depression domain rose from 3.77% in 2008/9 to 6.05% in 2009/10.

And 12.92% of patients were exception reported for indicator DM23, the controversial indicator that rewarded GPs for reducing HbA1c levels in patients with diabetes to below 7%.

Exception reporting rates are on the rise