quality and outcomes framework assessor training qof basics domains, evidence and local frameworks
TRANSCRIPT
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Quality and Outcomes Framework Assessor Training
QOF Basics
Domains, Evidence and Local Frameworks
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Plan!
• Overview of QOF
• Domains
• QMAS
• Sources of Evidence
• Developing Local Frameworks
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QOF Improvement Cycle
Review
QOF IMPROVEMENT
CYCLE
Planning
ActionLearning
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QOF 2004/5
Feb 2004 Agree
aspiration
Apr 2004Pay QPrep and QuIP
DES
April 2004QOF goes
live
April 2004DH guidance
on review visits
End April 2004
Monthly aspiration payments
August 2004QMAS system
goes live & provides monthly feedback
Oct 04 – Jan 05
Annual review visits take
place
April 2005 Achievement
payments made
QOF Activities for 2004/5
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Quality and Outcomes Framework (QOF)
• New primary care tool and major source of new funding
• Four domains - Clinical, organisational, patient experience and additional services
• Focused on the improvement of quality and outcomes of patient health
• Evidence based indicators
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Structure of the QOF
1050 points available• £75 per point 04/05• £120 per point 05/06
4 Domains:– Clinical – Organisational– Patient Experience– Additional Services
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QOF Domains
• Clinical domain– 10 disease areas– 550 points
• Organisational domain– 5 areas– 184 points
• Additional Services domain– 4 areas– 36 points
• Patient Experience domain– 2 areas– 100 points
• Holistic Care, Quality Practice and Access Bonus Points– Total 180 points
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Clinical Domain
• The 76 Clinical Indicators split into 3 types– Structure – e.g is a
disease register in place– Process – e.g is the
indicator being measured and an appropriate intervention being made – for what % of relevant population
– Outcome – how well is the condition being controlled – across what % of the population
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Payments
• New money in primary care• Aspiration payments (monthly from April 2004)• Achievement (lump sum in April 2005)• £s per point
– 2004/05 = £75– 2005/06 = £120
• List size• Prevalence• Pre-payment verification
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IM&T and Data Flows
• Practices require an RFA99 compliant clinical system
• Reports from QMAS – monthly to PCTs, at least
monthly to practices
• QMAS reports will, in time, have comparative data on achievement and trends – local and national
• Impact of Freedom of Information Act– January 2005
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QMAS
Quality Management Analysis System
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Principles• Not patient based data
– Pre-populated with IAU data
• Single national system ensures:– High trust and transparent– Changes to QOF scheme can be supported– Payments calculated on a consistent basis for all
practices– Single feed to NHAIS payment system– Practice and PCT access to same information
based on access rights– Reduced dependence on individual suppliers– Value for money
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Other achievement data – web interface QMAS Central
Server
PCTPayment
Agency
NHAIS
Confirm Achievement
Automated
“Manual”
Achievement data from clinical system
GP Practice
BACS Payment
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PCT
GP Practice
QMAS Central Server
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Evidence
• Information the practice must submit in advance of the visit together with guidance for PCO assessors
• Grades of Evidence– Indicator– Written Evidence– Assessment Visit– Assessors’ Guidance
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Local Frameworks
• Who can develop local QOFs?– PMS– APMS– PCTMS
• Local variations must have comparable frameworks
• Must be points based and add up to 1050
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Continued…
• Local QOF must be agreed by Director of Public Health or another suitable person
• Equally, should be similar reward for similar effort between national QOF and locally agreed variants
• All practices participating in a QOF should have a QOF assessment visit
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Summary
• QOF will drive local quality improvements in primary care
• Lay assessors will bring objectivity and patient focus to visits
• Local ‘intelligence’ important to know (K2)
• Part of a world first!