This page can now be utilised for QOF
review visits carried out from April 2008 to March 2009.
The aim of the website is to aid the reviewer
in conducting visits for review of the Quality and Outcome
Framework (QOF). Practices may also wish to read some of the
material to help them prepare for their review visit. The
principles of the visit have been designed by the Winter Group and
informed by the supporting documents to the General Medical
Services (GMS) contract. Much of the guidance to the reviewer
and the evidence that the practice is required to submit is taken
directly from these documents. This website refers only to
review visits carried out in Scotland.
The QOF Review Process has four main
purposes:
- To review the practice’s achievement of QOF in the previous
year, and to consider with the practice their likely achievement in
the current year;
- To review the practice’s procedures for data collection in
relation to disease management and the other sections of the
QOF;
- To review specific examples of good practice and offer support
where improvement might be achieved;
- To facilitate formative discussion on any changes to the QOF
agreed as part of the GMS Contract review.
Much of the evidence required to confirm levels of achievement
will be collected by an IT system called Quality Management and
Analysis System (QMAS). This is particularly true for the clinical
domains. The visit will cover the QOF indicators, and the
indicators in the contractual and statutory section of the
contract. NHS Boards may wish to cover other areas during the same
visit.
The core information available to the PCO QOF
review team will be the standard Quality Management and Analysis
System (QMAS) report. Also Grade A evidence will be submitted
but in this and subsequent years, only the core Grade A evidence is
needed unless the practice feels significant change has
occurred. The evidence submitted will be in respect of the
QOF for the year just ended.
The Winter Group recommended that during a
typical QOF review in 2008/09 3-5 clinical areas will be reviewed
(minimum of 3). Where smaller numbers of clinical areas are
selected, these would generally be reviewed in greater depth.
In general the QOF review team would expect to select more areas
than the practice, except when 4 are selected in which case equal
numbers would be selected by each party. At least 2
organisational areas (1 identified by the QOF Team and 1 by the
practice) should be reviewed. All aspects of the Patient
Experience domain for which the practice has claimed should be
reviewed in detail. NHS Boards may wish to cover other areas
during the same visit.
It is important to note that this visit is
separate from the payment verification which is carried out by the
NHS Support Services Scotland - Practitioner Services Division with
all the practices subject to random sampling for verification
purposes. Hence, the QOF review visit can be formative in
nature.
The role of the reviewer is very important.
The reviewer should perform the visit in a friendly and courteous
way. Seeking information should be carried out in a professional
manner. Difficult areas need to be tackled and not avoided but
dealt with sensitively. Skills used in the consulting room or
during appraisal can be utilised such as open questioning,
reflection and awareness of body language.