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Welsh QOF changes for 2015-17

Details of how the 102 points will be removed from the QOF in 2015, including retired indicators, amended indicators and new additions.

(Picture: iStock)
(Picture: iStock)

The Welsh government and GPC Wales have agreed a deal that will see 102 points removed from the QOF for 2015-17. Funding for these points, which is worth approximately £15,800 to the average practice, will be transferred to the global sum.

GPC Wales says that the indicators to be removed are considered ‘embedded in general practice’.

Changes to cluster networks

The Welsh deal for 2015-17 also includes changes to the cluster network development domain for 2015/16 to support the Welsh government's three-year plan for developing primary care services. A summary of the changes can be found here. Full details are in the Welsh QOF guidance for 2015/16.

QOF clinical changes

Two new atrial fibrillation indicators will be introduced to replace retired indicators in the same domain. This will bring QOF into line with NICE guidance.

Separate chronic condition indicators for flu jabs have been bundled into two new flu immunisation indicators within the public health domain. A number of other indicators have also had their points' value adjusted to more accurately reflect their workload.

The wording for new and amended indicators will be available when full guidance for the QOF for 2015-17 is published.The indicators affected by the changes are listed below.

Retired indicators

CHD

  • CHD002:  % of patients with BP reading 150/90mmHg or less - 17 points
  • CHD005: % of patients taking aspirin, anti-platelet or anti-coagulant - 7 points
  • CHD006: % of patients with MI history taking ACE-I or ARB, aspirin or alternative, beta-blocker and statin - 10 points
  • CHD007: % of patients who have had flu jab - 7 points

Heart failure

  • HF002: % of patients with diagnosis confirmed by specialist assessment – 6 points
  • HF003: % of patients with left ventricular systolic dysfunction treated with an ACE-I or ARB - 10 points
  • HF004: % of patients with left ventricular systolic dysfunction treated with an ACE-I or ARB also receiving a beta blocker - 9 points

Stroke and TIA

  • STIA003: % of patients with a BP reading of 150/90 mmHg or less - 5 points
  • STIA007: % of patients taking an anti-platlet or anti-coagulant - 4 points
  • STIA008: % of patients with a record of referral for further investigation - 2 points
  • STIA009: % of patients who have had the flu jab - 2 points

Diabetes

  • DM008: % of patients with last IFCC-HbA1c 64mmol/mol or less - 8 points
  • DM010: % of patients who have had a flu jab - 3 points
  • DM015: % of male patients asked about ED in preceding 3 years - 4 points
  • DM016: % of male patients with a record of ED who have received advice and assessment - 3 points

Asthma

  • AST002: % of patients aged over 8 with a measure of variability or reversibility - 15 points

COPD

  • COPD004W: % of patients with a dyspnoea score greater than 3 who have a record of FEV1, those with a score of less than 3 have an agreed management plan - 4 points
  • COPD007: % of patients who have had flu jab - 6 points

Mental health

  • MH008: % of female patients who have had a cervical screening test - 5 points

Learning disabilities

  • LD002: % of patients with Down’s Syndrome who have a record of blood TSH - 3 points

Osteoporosis

  • OST002: % of patients aged 50-75 with a fragility fracture in who osteporosis is confirmed on a DXA scan and who are receiving a bone-sparing agent - 3 points
  • OST005: % of patients aged over 75 with a fragility fracture who are receiving a bone-sparing agent - 3 points

Rhuematoid arthritis

  • RA003: % of patients who have had a CV risk assessment - 4 points
  • RA004: % of patients who have had an assessment of fracture risk - 5 points

Medicines management

  • MM005: Practice meets the LHB prescribing adviser at least annually to agree 3 actions - 4 points [MM006 has been increased to reflect this retirement - see below]

Where points have increased

Indicator

New value

Dementia

  • DEM002: % of patients whose care has been reviewed in previous 15 months.

Increased by 13 points

 

28 points

Rhuematoid arthritis

  • RA002: % of patients who have had a face-to-face review in previous 15 months.

Increased by 5 points

 

10 points

Medicines management

  • MM006: practice meets the LHB prescribing adviser at least annually, agrees 3 actions and provides evidence of change

Increased by 4 points

 

8 points


Areas where indicators have been replaced: Atrial fibrillation

Retired indicators

  • AF002: % of patients whose stroke risk has been assessed using the CHADS2 risk score - 5 points
  • AF004: % of patients whose latest CHADS2 score is greater than 1 receiving anti-coagulation therapy - 6 points
  • AF005: % of patients who had a CHADS2 score of 1 in the previous 3 years receiving anti-coagulation therapy - 3 points

New indicators

  • AF006: The percentage of patients with atrial fibrillation in whom stroke risk has been assessed using CHA2DS2-VASc score risk stratification scoring system in the preceding 3 years (excluding those patients with a previous CHADS2 or CHA2DS2-VASc score of 2 or more) - 12 points (achivement: 50-90%)
  • AF007: In those patients with atrial fibrillation with a record of a CHA2DS2-VASc score of 2 or more, the percentage of patients who are currently treated with anticoagulation drug therapy - 12 points (achievement 40-70%)

New indicators

Flu

  • FLU001: The percentage of the registered population aged 65 years of more who have had influenza immunisation in the preceding 1 August to 31 March – 5 points (achievement: 55-75%)
  • FLU002: The percentage of patients aged under 65 years included in (any of) the registers for CHD, COPD, Diabetes or Stroke who have had influenza immunisation in the preceding 1 August to 31 March - 15 points (achievement 45-65%)

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