QOF is an NHS performance management system, whereby GP practices are encouraged to achieve standardised targets to improve care in certain key areas.
QOF key areas
The QOF system aims to improve quality of care in the following five key areas:
- Clinical: long term conditions, e.g. chronic kidney disease, heart failure, hypertension
- Public health: blood pressure 45+, obesity 18+ and smoking 15+
- Public health (additional services): cervical screening
- Public health (vaccination/immunisation): shingles, flu, etc. vaccines/childhood immunisations
- Quality improvement: optimising demand / capacity in general practice, and workforce and wellbeing
The QOF targets are assessed on a yearly basis, running from 1 April to 31 March.
An example of a target (aka. ‘indicator’) would be the proportion of patients with coronary heart disease who’ve had their cholesterol measured within the QOF year.
What is ‘fundamental care’?
The work that you do for QOF is an integral part of a your job. It is about providing the best fundamental patient care you can, particularly for those with long term conditions.
This is done by engaging in proactive care - helping patients keep healthy, rather than waiting until they become ill before acting - and is accomplished by:
- ensuring that long term conditions (LTCs) are regularly monitored,
- health data is continually updated,
- screening programmes are delivered, and
- vaccinations are administered.
The pink alert box
The pink alert box is a form of notification for required or overdue patient tests/reviews/data that pops up as soon as someone opens a patient's notes.
For more detail on this, see our page Pink Alert (QOF) Box
What to do with a notification
If you see a notification in the pink alert box -> ensure that the appropriate action is taken while you have that patient's attention.
Care Navigators, Welcomers and Clinicians are all responsible for actioning notifications in the pink alert box as part of their job roles.
By ‘actioning’, we mean:
- For tests / reviews / treatments that are due (or overdue):
- perform the test/action required.
- if you cannot perform the action directly → encourage the patient to book an appointment for it.
- Gather any missing data.
If you need guidance on the requirements for a given check/review → find the relevant LTC page on the Penrose Portal.
📞 Phone Consultation
If you are in a telephone consultation with a patient and you see an alert, then:
- encourage the patient to take action for the alert (e.g., make an appointment in the surgery),
- record your conversation in the notes and be clear about the patient's response - if they are refusing to take action, then document this and their reason(s) if they give any.
Coding your actions
Actioning an indicator is one part of managing QOF targets. The other is correct coding.
After actioning a notification, you must use the correct code in the patient’s notes to ensure that this is counted toward the QOF target. This is not an easy thing, but there are a few things you can do to increase your probability of coding correctly:
- Always use the Penrose templates on EMIS. The templates are designed using the correct codes so you don’t have to worry about it!
- Look for the yellow QOF tag next to the notation. For example:
- Don’t use the yellow QOF tag unless you are sure. If there is not yet a diagnosis and you are not currently making a diagnosis -> use the term 'Suspected', not the yellow QOF tag.
- If in doubt → ask your Lead or your colleagues on Teams (so that the Data Quality Team (DQT) can also see the query and ensure all are on the same page), or ask the DQT directly.
QOF invitation codes
Use QOF-labelled invitation codes sparingly and only when they are truly appropriate (like when a person really does not want a test or review!).
QOF Invitation Codes are codes used when inviting a patient for a specific LTC review. Beware when using these codes…once a patient has been invited twice for a a QOF test/jab/review, that patient will be automatically removed from the QOF register. This may not be appropriate for that patient.