With only two weeks left until the end of the QOF year, have you done everything necessary to ensure maximum QOF success?

With the Vaccination and Immunisation indicators being one of the conditional indicators, achievement will feel like a harder than usual slog to many.

So, if you’re feeling like the end of the year is approaching like a train thundering down the tracks, what do you need to do to make sure you’re on board as it leaves the station?

QOF in 2021/22 was upended in December due to the impending Omicron wave, and arguably we’re still seeing a fair amount of pressure from COVID-19 at the moment.

As a result of the capacity issues faced by general practice, currently unresolved, some of the QOF achievement was protected. This income protection extended to 389 points with an expectation that practices would still keep doing the work, prioritising by clinical need. With 246 of the available 635 points being awarded on a conditional basis, how on earth do you prioritise what to look at first?

With a chunky 64 conditional points, the Vaccination and Immunisation domain is worth a whopping £201.16 x 64 = £12,874.24 to the “average” practice.

Achieving the incredibly high thresholds set for this domain, however, may be easier said than done, as despite having the ability to add Personalised Care Adjustments for the cohort for Shingles, the same latitude does not apply for the Childhood Immunisation indicators. If you’re struggling with uptake, the best advice we could give would be to run a real push on those who haven’t been vaccinated as yet, especially if you’re just one or two short. We’d also suggest that you check your non-achievers for coding issues, as something as small as coding a dose rather than the necessary booster code, could send your performance spiralling.

Prevalence plays a large part in deciding which of the remaining indicators are the next to tackle. Atrial Fibrillation (AF) has 30 conditional points attached, and with prevalence nationally for AF sitting at 2%, you’ll likely have fewer patients in this group to tackle than others. You can check the national prevalence for disease categories here.

Heart Failure, Diabetes and CHD are next, followed by Cervical Screening, while the remaining indicators languish some distance behind.

If you can achieve the AF, HF, Diabetes and CHD points, along with Cervical Screening, you’ll have achieved 112 points, worth on average £22,529.92. If your prevalence exceeds the national average, and taking into account any adjustment for list size, you may find that this is worth more to your practice.

Add in the 64 challenging points for the Vaccination and Immunisation domain and you’re 176 points into the 246 conditional points. The remaining indicators would total £14,081.20 for the average practice.

Any work you do now, in terms of case-finding for chronic disease, will increase your prevalence for next year as the cut-off date is now 31^st March. If you’ve done all you can to achieve this year’s QOF, spending some time looking at your prevalence is time well spent.

Once we see the end of the year in sight, we’re looking towards the horizon and the contract for next year.

We’re expecting to see some changes to the targeting for online appointment availability, and some tweaks to what practices are expected to offer online. Hopefully, this will be realistic and after some start-of-year adjustments to clinics, rotas and appointment types, will hopefully be plain sailing.

The Access to Health Records Act (ARHA) changes should mean less work related to deductions for deceased patients. Processes will need to be amended for access under the ARHA, as these are currently forwarded and often the requests and reasons behind the requests are complex.

Changes to vaccination and immunisation are afoot, with some minor changes to schedules and doses. Practices will be asked to support a campaign to get the uptake of child imms to pre-pandemic (or better) levels, though given the difficulties practices have faced with uptake this year, this may be challenging.

We’re not expecting to see new additional indicators added to QOF, but there will be Quality Improvement modules around access and prescription drug dependency.

More widely, changes will be seen within the PCN DES and IIF, with much of the information about the next 12 months already released. With an increasing focus on working at scale through PCNs and the new Integrated Care Systems, the new GMS contract negotiations looking to the contract from 24/25 will be interesting. The current funding deal runs until 23/24, and with upward pressure from inflation and salary increases, general practice will no doubt be looking for some changes to redress the balance.