Review of the Quality and Outcomes Framework (QoF)

Background

The national Quality & Outcomes Framework (QOF) was developed as an integral part of the new General Medical Services contract introduced across the UK. The QOF was seen as an innovative tool to support the continuous improvement of the quality of care provided to patients and the remuneration practices receive for delivering that quality. Participation in the QOF is voluntary; however from the outset it was envisaged that most practices would wish to work to deliver care to the standards set out. Although the QOF was negotiated as part of the nGMS contract it is also used by many practices under other contractual arrangements, such as 17C and direct provision; so that overall in Scotland more than 95% of practices are involved.

The negotiation of the nGMS contract recognised that the QOF would be reviewed and updated as necessary in the light of changes to evidence base, advances in healthcare, changes in legislation or regulation and the need for further clarity or so as to include new areas. It was agreed that an independent UK-wide expert group would oversee this process. The group would be tasked to consider the latest evidence available and make recommendations to the 4 Health Departments, or their agents and the GPC. It was agreed that the review process should take effect from April 2006.

Review Process

A UK QOF Review Steering Group (sub group of the nGMS Plenary Group) jointly Chaired by NHS Employers and GPC and including membership from all 4 UK Health Departments has been established to oversee the work of the Independent Review Panel (known as the Expert Team) who will conduct the actual review. This Expert Team will look objectively at all proposals for new indicators for changes to the current QOF and make recommendations to the sub-plenary group. The latter will agree final recommendations to be submitted to the Plenary Group for sign off.

In practical terms this means that any party wishing to propose changes to the QOF must submit evidence for new quality indicators and changes to the current ones to the Expert Team who will then examine the proposal and subsequently make a recommendation that will be the subject of negotiation between NHS Employers and BMA.

The composition of the Expert Team is expected to be announced shortly, selected from a short-list of organisations and academic institutions which have bid to undertake this work. The Team will ask for evidenced proposals for change from interested parties and set the pro forma for these to be submitted, including criteria for evidence.

The timescale for the submission of evidence is from mid April, with a deadline for submissions of end May 2005

The pro forma to be submitted can be located at www.midrec.bham.ac.uk/qof.

Further information on the review process can also be found on the NHS Employers website.