The new personalised care adjustment

With all the frenetic PCN activity that’s currently going on, plus the additional work that needs to be completed at this time of year, you may be forgiven if you missed the significant QOF changes that were introduced on 1^st April 2019.

While there’s been a big upheaval in points coming and going, in this instance I’m referring specifically to the introduction of the Personalised Care Adjustment and how this has replaced what was Exception Reporting, which will of course affect all of us in the primary care community.

Why change?

The reasons that have been stated by NHS E are that exception reporting didn’t provide any specific reason and was a catch-all that could potentially be abused. This statement has also been embellished by the regulatory authorities, stating that those practices that were higher than normal exception reporters were often seen as those providing a lower quality of service.

What’s new?

Practices are now able to differentiate between five reasons for removing a patient from an indicator, these being:

• Treatment unsuitable for the patient
• Patient chose not to have treatment following a conversation with the nurse
• The patient didn’t respond to offers of care
• Service not available
• Patient is newly diagnosed or newly registered

As with exception reporting, applying a personalised care adjustment to the patient record will remove that patient from an indicator denominator, should that QOF define intervention not been delivered.

For further information, including the principles that apply when using a personalised care adjustment, the criteria and an interpretation of this new requirement, please refer to the new Personalised Care Adjustment Policy [PLUS].