QOF: What’s changing?

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NHS England’s overview of the GP contract for 2023/24 details changes in several key areas for practices. Notably, this includes updates to the Quality and Outcomes Framework (QOF) and with it, a ‘streamlining’ of indicators.

With 23/24 marking the end of five-year framework agreement from Investment and Evolution, NHS England will now seek to engage stakeholders across the system to input into QOF’s future direction and form over the next few years.

As we await the outcome of that endeavour and publication of the full GP contract, we unpack some of the key takeaways and updates to QOF for 23/34.

Reduction in indicators

Under new proposals, there will now be 55 indicators in place of the previous 74. All register indicators are to be protected with an aim to release £97m in funding.

Changes to indicators will include a new overarching indicator for mental health and two further indicators for cholesterol. Additionally, indicator AF007 will be replaced by the new AF008 for atrial fibrillation.

QI to focus on wellbeing

In recognition of the current demand pressures facing general practice, quality improvement modules for QOF in 23/34 will centre around workforce and wellbeing.

In particular, proposals note the use of data to optimise demand and capacity in general practice, analysing avoidable appointments and the utilisation of wider services in the community.

Changes to childhood immunisations

Updates include removal of the payment clawback for performance below 80% coverage across routine childhood programmes, and removal of the vaccination and immunisation (V&I) repayment mechanism.

There are also changes to childhood V&I indicators. Notably, a reduction in lower thresholds for indicators VI001, VI002 and VI003 alongside a rise in the upper thresholds and the introduction of a ‘sliding scale of reward’.

The aim of these changes will be to ‘decrease the number of practices receiving no payment across the three indicators.’ Further details can be found here.

New Personalised Care Adjustment

Finally, proposals also note the introduction of a new Personalised Care Adjustment.

This will be for “for patients who registered at the practice too late (either too late in age, or too late in the financial year) to be vaccinated in accordance with the UK national schedule (or, where they differ, the requirements of the relevant QOF indicator).”

The Livi take

The reduction in QOF indicators and ‘streamlining’ detailed by proposals are some positive steps for practices that are working under immense pressure at present. As is the focus on workforce and wellbeing within quality improvement modules.

Indeed, these changes have been welcomed in some quarters, most notably the NHS Confederation as measures that could help to free practice time:

“The focus on access and freeing clinician time via reducing QOF and IIF indicators, as well as not introducing anymore service specifications, is rightly placed.”

However, there still remains significant challenges for general practice, most notably the current mismatch between demand and available capacity. And understandably, there have been calls for further simplification of QOF to reduce bureaucracy.

How Livi can help

Livi can help practices attain QOF and ease current pressures. We deliver digital primary care capacity through our Livi Practice service, which supports practices and systems with additional appointments.

Mjog, our patient messaging platform, offers surgeries a tried and tested solution to help practices improve QOF results. From appointment reminders to remote monitoring questionnaires, we enable practices to engage patients at scale and reduce DNAs.

If you would like to learn more, contact our team:

Further reading