It seems hard to believe, but we’re once again at that time of year when QOF is high on the agenda of practice managers. For most, the submission deadline involves a mad dash to ensure as many processes are completed as possible because, after all, points mean prizes for practices!
This yearly cycle is clearly a headache for practice managers struggling to cope with the pressures of the role, but just how do you go about spreading the QOF workload so that it doesn’t cause so much angst come deadline day?
Most PMs that don’t worry about the QOF deadline agree that practice processes need to be spread across the year – and that involves getting the whole practice team on board.
“Practice managers need all admin processes, not just those involving QOF points, to become part of everyday work if they are to run seamlessly,” one PM told us. “We simply haven’t got the capacity to be playing catch-up when deadlines approach, so processes need to be clearly laid out and adhered to.”
That’s clearly easier said than done, of course, which is why regular communication is recommended. “If you do something often enough it will eventually become second nature, so start by regularly reminding people of the processes and their responsibilities,” said the PM. “Send emails weekly or monthly, provide updates on QOF performance in meetings, display stats on staff noticeboards, raise it in meetings…do whatever it takes to keep the concept of QOF and what needs to be done fresh in people’s minds. Plus, set targets for people to work with – this I find helps to motivate people.”
The problems with GPs
One suggestion we heard for encouraging staff to keep on top of QOF is to incentivise people financially. This should apply equally well to GPs too – it’s worth reminding them that QOF points directly result in more income for the practice.
However, as a current thread on the Practice Index Forum is discussing, GPs can often be the weak link when it comes to QOF, often failing to obtain the relevant information. While partners should feel the non-achievement in their pocket, locums certainly don’t – which means other techniques need to be used. Here are a few ideas:
Give yourself time
QOF has been designed as an ongoing process – so try to work towards goals throughout the year. Writing on the Practice Index Forums, PMs suggest a couple of different ideas.
One is to do everything by month of birth. “This means we can plan work easier and it also means we can get everyone in for everything in one go, which seems to work well,” they shared. “We looked at which month had the least births and luckily it was September so we did all our housebounds then and were able to give them flu.”
Another PM suggested: “We have changed most of our recalls so that they fall between April and December, which means that most of the work is done long before the year end. We also have someone validating registers regularly throughout the year.”
Get recalls right
At the heart of successful QOF work is the need to get recalls in order. PM Polly, writing in a previous blog post on the topic for Practice Index suggests that it pays to train up at least one member of staff really well to get the recalls done. Get them to understand the work and also encourage common sense. You might not need to call in a patient for a diabetic check if they’ve already had a review in hospital for instance.
Software solutions abound and can really help practices drive patient communication to the right people at the right time. However, these simple indicator-identifying and recording software packages are only as good as the people using them, so ensure everyone knows how to use these and that they are working in consistent and agreed ways.
When it comes to communication, use technology such as text messaging to quickly contact multiple people in one go.
IT is important, but so is teamwork. For example, stopping smoking can be as much a part of the admin team’s remit as it is the clinicians, with the staff routinely sending letters and information about quitting smoking to targeted patients. Incentivise the whole admin team to hit targets as a group, if you think it’s appropriate.
Data is your friend
Your database is your gateway to more QOF points and therefore more income. So, invest time in verifying disease registers. Should all patients still be there? Is the diagnosis correct/still relevant? This is absolutely vital work if you are to have complete, robust datasets on which to base your recalls and subsequent consultations and tests.
Then, use the data that’s available to you. For example, you can boost pregnancy flu vaccines by pulling a list of patients off the midwife list and inviting them in for a jab.
Name and shame
And finally, what has to be a PMs favourite – is naming and shaming. One practice manager we know publishes regularly updated league tables stating exactly how many (or few) QOF points each GP or nurse has obtained in their designated clinical indicators.
Overall, QOF is an important contributor to a practice’s income. By ensuring it’s a year-round task and some straightforward processes are put in place, there’s no need for it to become a year-end headache.
Helpful: QOF toolkit for SystmOne users [PLUS]
The QOF plotter is a handy little tool to help you track and maximise QOF and can be accessed here.
How have you improved your QOF scores? Share your hints and tips by commenting below or in the Practice Index forum discussion thread here.
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