To make the QOF more manageable for practices, the trick is to spread work out throughout the year so it is not a mad panic in the last quarter. This is easier said than done but below are some tips for how you might do this:
- Learn how to use your clinical software to maximum advantage where QOF is concerned. Unlike most enhanced services for which practices have to craft their own monitoring systems, the clinical software usually has a good QOF management tool and learning how to use this to its best effect will reap dividends.
- Consider how to best organise your review system. One way is to do an annual review on patients’ birthdays. To do this set up searches to look for all patients with a birthday on, for example, 1 September and then an administrator can check which have QOF alerts and invite patients in to a one stop shop for all of their QOF targets, with a nurse or HCA first and then with the GP. This takes a lot of work the first year, but makes life a lot easier in subsequent years and it means patients are not being called back multiple times for different QOF indicators.
- Focus on priority areas. Have a look at your lists; which clinical areas are the most critical for your practice. If you have a high prevalence of diabetes you could start by running diabetic clinics and focusing on getting all of these patients done first.
- Use admin staff to monitor the QOF. Explain to them what the QOF is, why it is important to get patients in and give them time to monitor this on a weekly basis and call patients in to free nursing slots. This is particularly important in the summer months as there may be free capacity and you can get ahead with asthma checks for children while they are on school holidays, for example.
- Train HCAs in smoking cessation and give them time to call patients in the afternoon or evening. If are HCAs trained in how to ask the questions and offer follow up sensitively this may increase the amount of smoking cessation advice you can give via telephone rather than patients needing to come to the surgery.
- Give staff (either clinical or non clinical) ownership over particular areas and ask them to chase the rest of the team to complete their responsibilities. Staff can be more motivated if they are in charge of particular targets - rather than being one of a group of people with responsibility where it is easier to escape scrutiny.
Fionnuala O'Donnell is a practice manager in Ealing, West London, and a CCG board member.