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COPD QOF tips

Tips for improving QOF scores in this area and current indicators for 2013/14.

Picture: SPL
Picture: SPL

Tips for improving achievement

Somerset GP Dr Steve Holmes, education lead for the Primary Care Respiratory Society, says GPs should remember that a lot of patients with diabetes, hypertension and heart disease may also have COPD. 'It’s worth thinking about checking them,' he says. 'Also, remember that by the time people stop smoking, they may have developed COPD.'

He adds: ‘A rapid screening assessment of FEV1 will determine whether someone has potential COPD and should be offered formal spirometry. Good micro spirometers measuring FEV1 and PFR can cost about £50 and provide a quick and effective screening tool, with a result within a few seconds.

'Without that you will be doing probably five times more spirometry than needed. The microspirometer can also allow you to measure FEV1 quickly in a review, rather than full spirometry - and allow the time saved to be used for more discussion with patient or other clinical tasks.'

COPD005 requiring practices to make a record of oxygen saturation value is a new indicator for 2013/14. The Business Rules require that a record that pulse oximetry has been performed and the resulting oxygen saturation value are recorded to meet the requirements for this indicator.

In Wales, the QOF for 2013/14 also includes the addition of COPD100W, which asks practices to record an offer of referral to a pulmonary rehabilitation programme within the preceding 15 months. This indicator was deferred for inclusion in the QOF in England until 2014/15 due to concerns about the availability of pulmonary rehabilitation programmes for clinicians to refer to.

Welsh guidance states: 'Patients who have previously completed a pulmonary rehabilitation programme will need to have a "pulmonary rehabilitation programme completed" code in their patient record. These patients will then be excepted from this indicator.'

Current indicators

COPD indicators Points Achievement thresholds

COPD001: The contractor establishes and maintains a register of patients with COPD.

3

 

COPD002: The percentage of all patients with COPD (diagnosed on or after 1 April 2011) in whom the diagnosis has been confirmed by post bronchodilator spirometry between three months before and 12 months (15 months in N Ireland) after entering on to the register.

5

45-80%

COPD003: The percentage of patients with COPD who have had a review, undertaken by a healthcare professional, including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months (15 monhts in Wales and N Ireland).

9

50-90%

COPD004: The percentage of patients with COPD with a record of FEV1 in the preceding 12 months (15 months in Wales and N Ireland).

7

England: 40-75%

Wales: 40-75%

Scotland: 50-85%*

N Ireland: 40-75%

New indicator
COPD005:
The percentage of patients with COPD and Medical Research Council dyspnoea grade ≥3 at any time in the preceding 12 months (15 months in Wales), with a record of oxygen saturation value within the preceding 12 months (15 months in Wales and N Ireland).

5

40-90%

COPD006: The percentage of patients with COPD who have had influenza immunisation in the preceding 1 September to 31 March.

6

England: 57-97%*

Wales: 54-94%*

Scotland: 50-90%*

N Ireland 65-90%*

New indicator (Wales only)
COPD100W:
The percentage of patients with COPD and Medical Research Council dyspnoea grade ≥3 at any time in the preceding 15 months, with a subsequent record of an offer of referral to a pulmonary rehabilitation programme within the preceding 15 months.

5

40-90%

*Indicates a threshold that has changed for 2013/14

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