By Alisdair Stirling
Exclusive: GP practices are set to lose out financially because of changes in the QOF business rules to the way depression and hypertension indicators are being assessed.
The NHS Information Centre changed the rules without consulting GPs or publicly announcing the amendments, meaning official QOF guidance is now incorrect.
Dr Gavin Jamie, a GP in Swindon who runs the QOF Database website, spotted the changes after finding an anomaly in his practice's depression figures. The DEP 3 indicator is based on the percentage of patients who have had a further assessment of severity five to 12 weeks after new diagnosis of depression.
The change affects the number of patients on which the percentage is based: ‘Whereas previously, patients who had been diagnosed with depression in the previous QOF year were not included if they hadn't had their second assessment in that year, they will now be counted.'
A similar change to the hypertension rules has also been introduced without warning. Both could mean practices gain fewer points despite having done the same amount of work.
Dr Jamie said: ‘The DEP 3 indicator is worth 20 points, so a practice could potentially lose hundreds of pounds per indicator through a change like this. There probably is an argument for it, but it's the way it's being done that's wrong. They've not actually told anyone - other than through the business rules which are not widely read. Arguably, this a change that should have been negotiated and was done on the quiet.'Blood pressure monitoring QOF coding tips
A chunk of every practice's core income is at risk if new commissioning targets are not met.
The QOF will have stronger links between earnings and health outcomes, and GMS will be merged with PMS into a single contract, to be held by the new NHS Commissioning Board. Find out more at the Advanced Practice Management seminar on 25 November – London and 2 December, Manchester. Click for more details