QOF Reviewer Training


 
 

The information on these pages can now be utilised for QOF review visits carried out from April 2009 to March 2010.

 

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:

  1. 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;
  2. To review the practice’s procedures for data collection in relation to disease management and the other sections of the QOF;
  3. To review specific examples of good practice and offer support where improvement might be achieved;
  4. 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.  Most of this information is also available on the Quality Data Analyser (QDA).  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.  Previous QOF practice visit report(s) will be available to the visit team.

 

The Winter Group recommended that during a typical QOF review in 2009/10 the visit team should review practice achievements using QMAS/QDA to identify potential areas for development and examples of best practice.  These areas will provide the focus of the clinical discussion, which is intended to be interactive.  The practice team may also choose to select particular areas for discussion during the clinical review session prior to, or during the visit itself.  In the organisational domain the visit team should review the full range of core Grade A evidence pre-submitted by the practice and identify potential areas for development and examples of best practice.  All aspects of the Patient Experience domain for which the practice has claimed should be reviewed in detail with specific focus ont eh new GP access survey indicators introduced in 2008/09 (PE7 & PE8).  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.


 
Some useful links:
These links are all from the Pay modernisation website:
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