Transcript Quality and Outcome Framework Lay Assessor Training

Quality and Outcomes Framework
Assessor Training
QOF Basics
Domains, Evidence and Local
Frameworks
Plan!
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Overview of QOF
Domains
QMAS
Sources of Evidence
Developing Local Frameworks
QOF Improvement Cycle
Planning
Learning
QOF
IMPROVEMENT
CYCLE
Review
Action
QOF Activities for 2004/5
Feb 2004
Agree
aspiration
April 2005
Achievement
payments made
Apr 2004
Pay QPrep and
QuIP DES
Oct 04 – Jan 05
Annual review
visits take place
August 2004
QMAS system goes
live & provides
monthly feedback
QOF
2004/5
End April 2004
Monthly
aspiration
payments
April 2004
QOF goes live
April 2004
DH guidance
on review
visits
Quality and Outcomes Framework (QOF)
• New primary care tool and major source
of new funding
• Four domains - Clinical, organisational,
patient experience and additional
services
• Focused on the improvement of quality
and outcomes of patient health
• Evidence based indicators
Structure of the QOF
1050 points available
• £75 per point 04/05
• £120 per point 05/06
4 Domains:
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Clinical
Organisational
Patient Experience
Additional Services
QOF Domains
• Clinical domain
– 10 disease areas
– 550 points
• Organisational
domain
– 5 areas
– 184 points
• Additional Services
domain
– 4 areas
– 36 points
• Patient Experience
domain
– 2 areas
– 100 points
• Holistic Care,
Quality Practice
and Access Bonus
Points
– Total 180 points
Clinical Domain
• The 76 Clinical
Indicators split into 3
types
– Structure – e.g is a
disease register in place
– Process – e.g is the
indicator being measured
and an appropriate
intervention being made
– for what % of relevant
population
– Outcome – how well is
the condition being
controlled – across what
% of the population
Payments
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New money in primary care
Aspiration payments (monthly from April 2004)
Achievement (lump sum in April 2005)
£s per point
– 2004/05 = £75
– 2005/06 = £120
• List size
• Prevalence
• Pre-payment verification
IM&T and Data Flows
• Practices require an
RFA99 compliant
clinical system
• Reports from QMAS
– monthly to PCTs, at least
monthly to practices
• QMAS reports will, in
time, have comparative
data on achievement
and trends
– local and national
• Impact of Freedom of
Information Act
– January 2005
Quality Management Analysis
System
QMAS
Principles
• Not patient based data
– Pre-populated with IAU data
• Single national system ensures:
– High trust and transparent
– Changes to QOF scheme can be supported
– Payments calculated on a consistent basis for all
practices
– Single feed to NHAIS payment system
– Practice and PCT access to same information
based on access rights
– Reduced dependence on individual suppliers
– Value for money
GP Practice
Automated
“Manual”
BACS Payment
Achievement data
from clinical system
Other achievement
data – web interface
PCT
QMAS Central
Server
Confirm Achievement
NHAIS
Payment
Agency
GP Practice
QMAS Central
Server
PCT
Evidence
• Information the practice must submit in
advance of the visit together with
guidance for PCO assessors
• Grades of Evidence
– Indicator
– Written Evidence
– Assessment Visit
– Assessors’ Guidance
Local Frameworks
• Who can develop local QOFs?
– PMS
– APMS
– PCTMS
• Local variations must have comparable
frameworks
• Must be points based and add up to
1050
Continued…
• Local QOF must be agreed by Director
of Public Health or another suitable
person
• Equally, should be similar reward for
similar effort between national QOF and
locally agreed variants
• All practices participating in a QOF
should have a QOF assessment visit
Summary
• QOF will drive local quality improvements in
primary care
• Lay assessors will bring objectivity and
patient focus to visits
• Local ‘intelligence’ important to know (K2)
• Part of a world first!