QOF Plus Year 1 - Imperial College London
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QOF Plus Year 1 - Imperial College London

QOF Plus Year 1 - Imperial College London QOF Plus Year 1 - Imperial College London

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Workload and training implicationsThere may be significant administrative workload implications and additional training for practiceadministrative staff may be required. NHS Hammersmith and Fulham will be able to provideadditional support and training for this process if necessary.The assessment and verification process for these indicators will be developed and refined duringthe course of the scheme. Payment will be based on a practice declaration of attainment, and anyverification will occur post-payment.For the + PRESCRIPTION 1 indicator it is expected that all repeat medicines issued fromcommencement of the scheme will have a diagnosis or symptom related to that prescription inthe patient’s active problem list. This includes any prescriptions that may only be issuedinfrequently or as required, such as prescriptions for gout medications or analgesia. It will not benecessary for an individual medication to be ‘linked’ to a symptom or diagnosis, but simply forthe symptom or diagnosis to be recorded in the active problem list. The workload for GPs isexpected to be in the form of a brief review and update of the active problem list wheneverrepeat medications are prescribed. This will significantly improve monitoring of chronicconditions and subsequently the quality of care for these patients.For the + REFERRALS 1 indicator, each practice will be expected to ensure a record has beenmade of referrals to secondary care outpatient clinics with diagnosis and symptom referred for,and specialty of referral. Emergency referrals to A&E will not be subject to this indicator. It isexpected that this will increase workload for GPs or administrative staff as they will be requiredto ensure that a proper record has been made.The identification of carers from new registrations for the + CARERS 1 indicator is unlikely to addmuch workload to the processes already required for new registrants. An additional question onexisting new patient questionnaires may be required if one is not already included, andadministrative staff may need to ensure that this question is answered by the new registrant.A consequence of the + PRESCRIPTION 1 indicator is that the final 4 indicators regarding practiceregisters for arthritis and eczema/psoriasis should naturally be populated. This should requireminimal additional work by the practice on top of that already undertaken, save to verify that theregisters are a true reflection of the practice’s populations with these conditions. For details of the proposed training package see section 14.3.6 (p95).62

References2001 Census web site: http://www.statistics.gov.uk/census2001/profiles, National Statistics Office,2003.British Association of Dermatologists (2006). Psoriasis guideline 2006. [Available online, Accessed27/11/2008]http://www.bad.org.uk/healthcare/guidelines/psoriasis_guideline_(Final_update)_280906.pdfDe Lusignan S & Teasdale S. The features of an effective primary care data quality programme.Healthcare Computing 2004; 95-102.Department of Health. Carers at the heart of 21 st century families and communities. London: HMGovernment; 2008.Department of Health, Social Services and Public Safety. Informal Carers Report, A report from theHealth and Social Wellbeing Survey 1997, Northern Ireland; 2001.Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. (2005) Prevalence andtreatment of psoriasis in the United Kingdom. Arch Dermatol 141:1537-41General Practice Research Database Group. GPRD recording guidelines for Vision users. London:MRHA; 2004.Gnani S & Majeed A. A user’s guide to data collected in primary care in England. Eastern Region PublicHealth Observatory; 2006.Green G, Bradby H, Chan A, Lee M, Eldridge K (2002). Is the English National Health Service meetingthe needs of mentally distressed Chinese women? J Health Services Research Policy 7:216-21.Griffiths CE and Barker JNWN (2007). Pathogenesis and clinical features of psoriasis. Lancet 370:263-71Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. (2004) Effect of a treatmentstrategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomisedcontrolled trial. Lancet 364:263–9Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, et al. (1994) The effects ofspecific medical conditions on the functional limitations of elders in the Framingham Study. Am JPublic Health 84:351-8Jordan K, Porcheret M and Croft P. Quality of morbidity coding in general practice computerizedmedical records: a systematic review. Family Practice 2004; 21: 396-412.Lukes S, Bell M. (2002) Renewing West London. Refugee communities: their hopes and needs. Abaseline study for Renewal. London: Michael Bell AssociatesMaher J & Green H. Carers 2000 Office for National Statistics, The Stationery Office: London; 2002.McCormick A, Fleming D, Charlton J. (1995) Morbidity Statistics from General Practice. Fourth NationalStudy 1991-1992. HMSONational Institute for Clinical Excellence (NICE) (2007) Rheumatoid arthritis: the management andtreatment of rheumatoid arthritis in adults, final scope. [Available online, Accessed 27/11/2008]http://www.nice.org.uk/nicemedia/pdf/RAScope.pdfNational Institute for Clinical Excellence (NICE) (2007a) Clinical guideline: atopic eczema in children[Available online, Accessed 27/11/2008]http://www.gserve.nice.org.uk/Guidance/CG57/Guidance/pdf/EnglishNational Prescribing Centre. (2006) MeReC bulletin - atopic eczema in primary care. [Available online,Accessed 27/11/2008] http://www.npc.co.uk/MeReC_Bulletins/2003Volumes/Vol14no1.pdfPrimary Care Dermatology Society & British Association of Dermatologists. (2005) Guidelines on themanagement of atopic eczema. [Available online, Accessed 27/11/2008]http://www.bad.org.uk/healthcare/guidelines/PCDSBAD-Eczema.pdfScottish Intercollegiate Guidelines Network (SIGN) (2000) Management of early rheumatoid arthritis.[Available online, Accessed 27/11/2008] http://www.sign.ac.uk/pdf/sign48.pdf63

References2001 Census web site: http://www.statistics.gov.uk/census2001/profiles, National Statistics Office,2003.British Association of Dermatologists (2006). Psoriasis guideline 2006. [Available online, Accessed27/11/2008]http://www.bad.org.uk/healthcare/guidelines/psoriasis_guideline_(Final_update)_280906.pdfDe Lusignan S & Teasdale S. The features of an effective primary care data quality programme.Healthcare Computing 2004; 95-102.Department of Health. Carers at the heart of 21 st century families and communities. <strong>London</strong>: HMGovernment; 2008.Department of Health, Social Services and Public Safety. Informal Carers Report, A report from theHealth and Social Wellbeing Survey 1997, Northern Ireland; 2001.Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. (2005) Prevalence andtreatment of psoriasis in the United Kingdom. Arch Dermatol 141:1537-41General Practice Research Database Group. GPRD recording guidelines for Vision users. <strong>London</strong>:MRHA; 2004.Gnani S & Majeed A. A user’s guide to data collected in primary care in England. Eastern Region PublicHealth Observatory; 2006.Green G, Bradby H, Chan A, Lee M, Eldridge K (2002). Is the English National Health Service meetingthe needs of mentally distressed Chinese women? J Health Services Research Policy 7:216-21.Griffiths CE and Barker JNWN (2007). Pathogenesis and clinical features of psoriasis. Lancet 370:263-71Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. (2004) Effect of a treatmentstrategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomisedcontrolled trial. Lancet 364:263–9Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, et al. (1994) The effects ofspecific medical conditions on the functional limitations of elders in the Framingham Study. Am JPublic Health 84:351-8Jordan K, Porcheret M and Croft P. Quality of morbidity coding in general practice computerizedmedical records: a systematic review. Family Practice 2004; 21: 396-412.Lukes S, Bell M. (2002) Renewing West <strong>London</strong>. Refugee communities: their hopes and needs. Abaseline study for Renewal. <strong>London</strong>: Michael Bell AssociatesMaher J & Green H. Carers 2000 Office for National Statistics, The Stationery Office: <strong>London</strong>; 2002.McCormick A, Fleming D, Charlton J. (1995) Morbidity Statistics from General Practice. Fourth NationalStudy 1991-1992. HMSONational Institute for Clinical Excellence (NICE) (2007) Rheumatoid arthritis: the management andtreatment of rheumatoid arthritis in adults, final scope. [Available online, Accessed 27/11/2008]http://www.nice.org.uk/nicemedia/pdf/RAScope.pdfNational Institute for Clinical Excellence (NICE) (2007a) Clinical guideline: atopic eczema in children[Available online, Accessed 27/11/2008]http://www.gserve.nice.org.uk/Guidance/CG57/Guidance/pdf/EnglishNational Prescribing Centre. (2006) MeReC bulletin - atopic eczema in primary care. [Available online,Accessed 27/11/2008] http://www.npc.co.uk/MeReC_Bulletins/2003Volumes/Vol14no1.pdfPrimary Care Dermatology Society & British Association of Dermatologists. (2005) Guidelines on themanagement of atopic eczema. [Available online, Accessed 27/11/2008]http://www.bad.org.uk/healthcare/guidelines/PCDSBAD-Eczema.pdfScottish Intercollegiate Guidelines Network (SIGN) (2000) Management of early rheumatoid arthritis.[Available online, Accessed 27/11/2008] http://www.sign.ac.uk/pdf/sign48.pdf63

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