QOF
Questions & Answers
QMAS
Can I as a lay reviewer access the
QMAS data online?
The QOF data is held on QMAS. This
applies to the current year’s data and also historical data down to
the fine detail which is covered in
reviewer training. Because QMAS is a
live working NHS service it is only accessible through the NHS
net. GPs and practice managers cannot access it through
computers linked to the general internet.
You can however get a great deal of the
QOF data for the end of the previous year on the Information
Services Division website. This is usually published around the
following July. The web address is http://www.isdscotland.org/isd/3313.html.
Is the end of year QMAS data always
the final agreed data source a reviewer should use?
In a small number of cases either the
Health Board or the practice can query the QMAS data and payment
may subsequently be modified. In this case, it is the new
agreed figures that should be used for the QOF review visit.
The Health Board will inform you if this is the case.
When I look at the QMAS data on a
condition I see a large number of exceptions for some indicators
but much less for other indicators in the same disease area.
Why is this?
The negotiated agreement is that if a
patient declines QOF care through not attending when asked three
times or giving a formal decline, the practice is still compensated
if some of the QOF work is carried out. For example, a patient with
diabetes may have declined to attend the practice diabetic clinic
but has had a BP check carried out opportunistically.
What do we do if we see a practice has
a higher than expected number of patients giving informed
dissent?
This can mean several things and the
numerical data in QMAS is only one source of information that a
reviewing team must use. Sensitive questioning of the practice team
members should provide the explanation. Remember that
comparative averages in this area of QMAS provide a comparison only
with what the Health Board and Scottish practices have actually
done and does not necessarily give a “right” answer.
When I access QMAS using the Health
Board level of access, I cannot easily find the practice figures I
want. Is there a smart way to change to a practice
view?
The straight answer is currently
“No”. The Health Board data is presented by indicator and not
by practice. The developers of the software that runs QMAS
have been asked to make this enhancement.
How do I print off the QMAS site?
If printing off from the QMAS site, choose Landscape as in
Portrait the columns to the right do not show.
Depression
What is the denominator for
DEP2?
Those patients with latest, first or new
episode of depression recorded between the preceding 1st
April to 31st March.
How is the prevalence for this area
calculated?
All patients who have been recorded as
having a first or new event of depression at anytime are
counted.
Can patients who have CKD whose
hypertension is well controlled be excepted from receiving ACE or
ARBs?
In the absence of proteinuria it is
acceptable to exception report patients from the requirement
for ACE-I/ARB prescription if their blood pressure control is
statisfactory. In the 2008/09 Qof this indicator has been
changed to read 'The percentage of patients on the CKD register
with hypertension and proteinuria who are treated with an
angiotensin converting enzyme inhibitor (ACE) or angiotensin
receptor blocker (ARB) (unless a contraindication or side effects
are recorded).'
How does the practice with an appointment system that
conducts 'emergency surgeries' qualify for achieving
PE1?
Practices can claim this payment if their normal booking
interval is 10 minutes or more.
'Normal' means that three quarters or more of their
appointments should be 10 minutes or longer. Deciding whether
a practice meets this requirement depends on the booking
system.
Practices with appointment systems
For practices where three quarters of patients are seen in
booked appointments of 10 minutes or more, and surgery sessions are
not normally interrupted by 'extras', the contract requirement is
met. Extras seen at the end of the surgeries and patients
seen in emergency surgeries should then not amount to more than a
quarter of patients seen.
How are QOF queries handled?