QOF Plus Year 1 - Imperial College London

Percentage of practices at or below given rate of exceptingNumber of H&F practices at or below given rate of exceptingException reporting patterns in Hammersmith and FulhamThe metric used to report exception reporting here is that published by the NHS InformationCentre: the effective exception rate, . The for a given practice or group of practices iscalculated by summing all the exception counts across all numeric indicators , and dividing thisinto the sum of the [denominator + exception counts]:∑ ∑(9)∑ (∑ ( ))While dealing with absolute numbers of exceptions rather than averaging reported ratesminimises the skew caused by practices with small numbers of patients, it also disproportionatelyweights large-denominator indicators (e.g. CS 1), and this should be kept in mind while reviewingthe figures. Those quoted here are derived from QOF 07/08 data. They differ slightly from thosepublished by the Information Centre because we disagree with their practice of assuming thatunreported data should be equivalent to an exception rate of zero for a given practice-indicator.Our view is more conservative (practice-indicators without a stated exception rate are simplyomitted) and yields a pessimistic upper bound on exception reporting.100%90%80%National QOF 07/08H&F June 083028262470%60%50%40%30%20%10%2220181614121086420%00.1% 0.5% 1.0% 5.0% 10.0% 50.0% 100.0%Exception reporting rateMediansFigure A2.7Cumulative distribution plot comparing rates of exception reporting in NHS Hammersmith and Fulham(June 2008 data, solid red line) with national rates (QOF 07/08 data, dotted purple line) for the 12 QOFindicators subject to QOF+ incentivisation. Data sourced from QMAS and the NHS Information Centre.The EER in national QOF 07/08 was 6.08% for all indicators and 7.50% when the 12 clinicalindicators included in QOF+ are considered in isolation. Hammersmith and Fulham’s rates are6.01% and 6.12%, respectively, ranking it 75 th and 9 th lowest for exception reporting by PCTnationally. Compared to London PCTs (EER 6.43% and 7.81%) Hammersmith and Fulham currentlyranks 8 th and 2 nd lowest. The cumulative distribution of exception reporting for the 12 clinical111