In recognition of the fact that it is not always possible for GP practices to achieve all the points in QOF, NHS Digital has produced a further measure of GP practice achievement. This measure takes account of instances where GP practices cannot achieve points because they have no patients pertinent to an indicator.
For example: In 2019-20 there are 559 QOF points available and 45 of these points are for asthma indicators but a GP practice does not have patients on their asthma register, (no patients meeting the established criteria). Then it would not be possible to achieve any of the points allocated to the asthma indicators.
Therefore, even if the GP practice achieved all the other points available, they would only be able to attain 91.9% achievement (514 points achieved/ 559 points available) * 100.
In these circumstances, the standard ‘points achievement’ measure can be misrepresentative and may result in a GP practice’s achievement apparently declining from one year to the next where they have patients on a register in one year but none in the next year.
To represent GP practice points achievement more fairly, NHS Digital calculates adjusted maximum points achievable for each GP practice, effectively removing points from the calculation denominator where both of the following conditions apply:
- the GP practice does not have any patients in the indicator denominator
- the GP practice has reported no PCAs for the indicator denominator
The indicator denominator plus indicator PCAs must equal zero. This ensures adjustment of maximum points achievable where there are patients on the relevant disease register (PCAs are included in the disease register, but not in the relevant denominator), who have not received the interventions.
For example, a GP practice with no patients on their asthma register, the GP practices maximum points available would be 514 (559 points minus the ‘unachievable’ 45 asthma points). In this case, the difference between the GP practice’s ‘points achievement’ and ‘points achieved as a percentage of QOF points available’ would be as follows:
(Points achieved / All QOF points) * 100 = Points achievement
(514 / 559) * 100 = 91.9%
(Points achieved / QOF points available) * 100 = Points achieved as percentage of QOF points available
(514 / 514) * 100 = 100%
Due to the complexities of calculating and presenting the ‘points achieved as a percentage of QOF points available’ figures, they are only provided for total points, not for any domain or group totals. The figures can be found in the ‘QOF 2019-20: Achievement at GP practice level, all domains’ workbook which is included in the publication.