Paul Midgley of the Healthcare Partnership reviews the impending new GMS contract-related ‘Quality and Outcomes framework’ (QOF) practice assessment visits that every PCT will be making on every practice across the UK during the period October 2004-January 2005. This article outlines the process, the concerns this will raise for practices, and how you can use this as an opportunity to support key practices in their hour of need and boost your credibility and contacts with key target customers into the bargain.
The new GMS contract, introduced into General Practices across the UK in April 2004, brings with it a platinum-plated, (voluntary) incentive scheme (QOF) for all practices to earn substantial additional income in addition to their guaranteed patient population-based monthly payments (known as the ‘Global Sum’ for GMS practices). Practices engaging in the QOF scheme achieve points by providing a wide variety of chronic disease management and practice organisation services to nationally prescribed standards (email HCP for details of the QOF scheme – see next page). An average sized practice, achieving full marks in the QOF scheme (1050 points), will earn an extra £78,750 in year 1 (April 04-March 05) and £126,000 in year 2 (April 05-March 06). It is estimated that by the third year of the contract, high achieving practices could derive a third of their income from the QOF! Needless to say, every practice is actively engaged in trying to gain as many points as they can – because as we know, points make prizes . . . With this much money at stake, the Department of Health has insisted that PCTs ‘risk manage’ the process by visiting each practice involved in the QOF scheme, to verify certain aspects of their compliance (including fraud prevention), and to help practices to aim high and achieve good results, as this benefits both patients and practices alike.
Where are we now?
Every PCT has now appointed QOF Assessment visit teams, each team comprising the following roles at a minimum:
Timings around the QOF Assessment Visits
Here are the timelines of the visit process, which all occurs within a 2 month period around the visit date itself. Every practice will be visited within the period October 2005- January 2006.
Outcomes of the QOF assessment visit for every General Practice
Areas of QOF requiring written evidence from the practice for the visit
Practices will be sent a 20-page pro-forma inviting them to submit written evidence of achieving standards against individual QOF indicators under the following headings:
|Records and Information about patients 19 indicators, 85 points), including Smoking Cessation and Blood Pressure measurement targets Information for patients (8 indicators, 8 points) – includes information about smoking cessation Education and training (9 indicators, 29 points), including PDP, appraisal, CPR training and Significant event reviews Practice management (10 indicators, 20 points), including Hep B vaccination status Medicines management(10 indicators, 42 points), including drugs for treating anaphylaxis, and medication reviews for all patients on repeat medicines Patient experience (4 indicators, 100 points), including running an approved patient survey and involving a patient group in the results feedback Additional services including: Cervical screening (7 indicators, 22 points) Child health surveillance (1 indicator,6 points) Maternity services (1 indicator, 6 points) Contraceptive services (1 indicator, 2 points)|
Support required to make QOF Assessment visit process a success
The following areas require training and meeting support:
What can you do?
Does your product help practices meet key targets outside the chronic disease areas where you may well have already been focusing, for example, smoking cessation? Are there any areas above where your company provides training or information that will help practices provide written evidence that they have achieved the required standards? Look carefully at the QOF indicator areas mentioned above (contact HCP for a copy of the full QOF indicators document).
|If your company does not provide the required services or support themselves, could you provide these to key practices via a third party supplier? (see below). Talk to key target GPs, or practice managers in target practices, to find out what their needs are around the new GMS contract, and discuss the QOF Assessment visits. Your help could range from simply providing lunch at a meeting they have already scheduled, to providing a bespoke workshop for a practice etc on a specific aspect of the visit process or follow up development action planning.|
What have you got to lose? Customers will be impressed at your knowledge, delighted that you are taking an interest, and keen that you are helping wherever you can. You in turn will gain better access to key customers, and will sell more as a result . . .
|If you would like further information on the training provided by the Healthcare Partnership, and the range of 25 topical talks and skills development workshops designed and run specifically for NHS and Pharma customers via our team of expert facilitators, then please call us on 0870 2413506 or email email@example.com Find out how we can help improve your access to key customers by providing ‘Preparing for your QOF Assessment Visit’ and other GMS contract related talks/workshops that attract good numbers of high quality customers. We can tailor these talks with a clinical slant if required.|