QOF Plus Year 1 - Imperial College London

The proposed methodology for selecting priority areas for development of indicators andthe methodology for indicator development was discussed. Both HL and RB supportedthe QOF+ Development team’s proposed approach of using a structure consultationprocess to select priority areas and applying evidence based criteria to select indicators.Advice was also sought from HL on the proposed membership of the local stakeholderpanel, and she agreed with the group’s proposals for this.The need for all LES schemes currently offered by the PCT to be incorporated into QOF+was discussed. HL and RB felt that the concepts underlying QOF were different in manyways from those underlying LES, and that the two schemes had different butcomplementary functions. It therefore may not be appropriate to combine all the LESinto QOF+.The need for strong IT support was emphasized to ensure indicators were workablewithin practice systems.The collection of good quality quantitative data would enable evaluation of the schemeto see whether a ‘step-change’ effect had occurred. HL also felt a qualitative componentwould be appropriate and helpful. RB mentioned that an evaluation would probablyrequire more than just QOF data. GPED data could be used and he highlighted thepossibility of finding a local comparator group.The need for engagement with all local practices was emphasized, as well as the need toprovide education and training support in addition to financial incentives.The relevance of the findings of the NHS Next Stage Review in terms of helping shape thedirection of the scheme.In terms of additional quality initiatives, the QOF+ Development team highlighted thatfinancial incentives in themselves don’t improve care, and that there were plans to put inplace a robust IT system and local support. RB mentioned the importance of tailoringadditional initiatives to take into account the stages that practices are at. e.g. leadingedge practices were likely to be able to work on their own initiative with minimumsupport. Practices in the mid-range may benefit from education, training and theopportunity to learn from colleagues. The tail end of practices may need other forms ofsupport, e.g. development of teamwork, leadership and management skills. He alsomade the point that in some cases, levels of practice achievement would be related tothe nature of the practice’s patient population. The QOF+ Development Teamhighlighted that within QOF+, there would be flexibility to add associated features e.g.GP peer support, management support etc.A1.4 ReferencesDarzi A (2008) High Quality Care for All, the final report of the NHS Next Stage Review Final Report byLord Darzi The Stationary Office. London101