Skip to main content

Publication, Part of

Quality and Outcomes Framework, 2020-21

Official statistics

Technical annex

QOF background

The Quality and Outcomes Framework (QOF) was introduced as part of the General Medical Services (GMS) contract on 1 April 2004. The objective of QOF is to improve the quality of care patients are given by rewarding GP practices for the quality of care they provide to their patients and is therefore, an incentive payment scheme, not a performance management tool.

A key principle is that QOF indicators should be based on the best available research evidence. Participation by GP practices in QOF is voluntary, though participation rates are very high, with most Personal Medical Services (PMS) practices taking part.

The QOF contains four main components, known as domains, these are:

  • Clinical
  • Public health
  • Public health - additional services
  • Quality improvement

Each domain consists of a set of achievement measures, known as indicators, against which GP practices score points according to their level of achievement.

The indicators included in the current reporting year are detailed in the accompanying 'Indicator definitions' file (available on the publication homepage) and details of changes to indicators by year are are shown in the relevant section in this document.

QOF information from previous years has been published by NHS Digital and is available at https://digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data, and via an online search function at https://qof.digital.nhs.uk/.

General Practice Extraction Service (GPES)

QOF data was collected from GP practices by GPES. GPES is a centrally managed service that extracts information from GP IT systems for a range of purposes at a national level. The GPES relays data to CQRS.

Calculating Quality Reporting Service (CQRS)

CQRS calculates achievement and payments on quality services, including the Quality and Outcomes Framework (QOF), as well as Enhanced Services (ESs) and some other clinical services (e.g. vaccinations and immunisations).

Summary of changes for 2020-21

To support the ongoing response to COVID-19 and the need to proactively target and support the most vulnerable patients during this period the following changes have been implemented in 2020-21:

  • Some indicators will continue to be paid based on practice performance. These are:
    • The four flu indicators targeted on patients with coronary heart disease, COPD, stroke/TIA and diabetes, will have the number of points attached to them doubled;
    • The two cervical screening indicators, will have the number of points attached to them doubled;
    • Register indicators.

The requirements of the Quality Improvement (QI) domain have been amended to focus upon care delivery and restoration of services using QI tools;

The remaining 354 points will be subject to income protection based upon historical practice performance and to practices agreeing an approach to QOF population stratification with their commissioner.

The total points available to practices is 567 and all payments will be subject to prevalence and list size adjustments.

Additional information can be found in the Guidance for GMS contract 2020/21 in England published by NHS England and NHS Improvement and GOV.UK - general medical services statement of financial entitlements (amendment) directions 2021.

These changes mean that the achievement and personalised care adjustment (PCA) data extracted for the 2020-21 reporting year could be misleading and not representative of activity undertaken, and any comparisons with data from previous years are not recommended.

PMS practices

PMS practices can negotiate local contracts with their commissioning organisations for the provision of all services. PMS practices may also participate in QOF, and they may either follow the national QOF framework or become part of local QOF arrangements.

PMS practices with local contractual arrangements are included in the published QOF information, and in the figures presented in the report.

Where PMS practices use the national QOF, their achievement (in terms of the maximum QOF points available) is subject to a deduction (approximately 100 points) before QOF points are turned into QOF payments. This is because many PMS practices already have a chronic disease management allowance, a sustained quality allowance and a cervical cytology payment included in their baseline payments.

GMS practices do not receive such payments but receive similar payments through QOF. To ensure comparability between GMS and PMS practices, the QOF deduction for PMS practices ensures that they do not receive the same payments twice.

As the report covers QOF achievement and not payments, all QOF achievement shown is based on QOF points prior to PMS deductions. This is to allow comparability in levels of achievement –where GMS and PMS practices have maximum QOF achievement, both are regarded as having achieved the maximum points.

Level of detail

There is no patient-specific data in CQRS because it is not required to support the QOF.

For example: GPSES captures aggregate data on patients with coronary heart disease and on patients with diabetes, but it is not possible to identify or analyse information about individual patients and therefore not possible to identify the number of patients with both diseases.

QOF data extraction and validation

QOF data is extracted from CQRS and in years prior to 2019-20 was processed and then passed to external regional local office representatives for validation.

In 2019-20 following the abolition of regional local offices and after consultation with NHS England and NHS Improvement this validation process was automated by NHS Digital to ensure consistent data quality.

The following validation rules are applied to the data sequentially for each GP practice:

  1. The total number of points achieved by a GP practice was less than or equal to the total number of QOF points that can be achieved for indicators which require a manual response (usually ‘yes’ or ‘no’) only.
  2. The GP practice closed before 1 April in the year of publication and this closure was recorded in the NHS Digital reference data before 1 July in the year of publication (data for 2020-21 are published in 2021).
  3. The GP practice status in NHS Digital reference data on 31 March of the reporting period was not equal to ‘A’ (Active).
  4. The number of registered patients at the GP practice was not available for any of the 3 months prior to 31 March of the reporting year.

The first validation rule that excludes a GP practice is recorded as the reason for exclusion from the publication, although a GP practice may fail more than one validation rule. Details of GP practices excluded for these reasons can be found in the PRACTICE_VALIDATION_OUTCOMES .csv which is part of the publication.

Practice list sizes

QOF data published for years from 2015-16 by NHS Digital uses GP practice list sizes on 1 April immediately following the reporting year end (31 March). In the context of this publication, these list sizes are used as the basis for the calculation of raw clinical prevalence.

Prior to 2015-16, GP practice list sizes on 1 January of the reporting year were used. These figures are still used in CQRS for list size adjustments in QOF payment calculations.

The sum of the GP practice list sizes for the GP practices included in the QOF publication can be found in the Data quality annex which is part of this publication. This number may contain duplicate patients where a patient has moved GP practice during the financial year; this is due to time lags in updates to organisation reference data.

GP practice mappings

Primary Care Networks (PCNs) were introduced into the National Health Service in England as part of the NHS Long Term Plan, published in January 2019, and form the building blocks of Integrated Care Systems. A PCN consists of a group of GP practices working together with a range of local providers (pharmacy, mental health, social care, community, and voluntary sector), serving a population of at least 30,000 and not tending to exceed 50,000. They build on the core of current primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care. PCNs have been included as a mapped GP practice geography from 1 April 2020.

GP practices have been mapped to their respective PCNs, CCGs, STPs and Regions using reference data current on 1 April of the year of publication. This mapping has been applied to data for both the current and previous reporting year; this should be borne in mind when making comparisons between years (please see the section ‘Comparing QOF data over time’).


Definitions

There is a distinction between:

  • Numbers of patients on disease registers for QOF indicator groups.
  • Numbers of patients relevant to specific indicators within these indicator groups.
  • Numbers of patients relevant to specific indicators who are included in the indicator denominator when measuring QOF achievement. 

 

Registers

Most indicator groups have an associated disease register (e.g. the atrial fibrillation indicator group is based on a register of patients with atrial fibrillation).

Some conditions do not have a disease register (e.g. the blood pressure indicator group is based on a count of those who have had their blood pressure taken, which is not a disease register).

The information systems which underpin QOF hold the numbers of patients on each of these registers, for each participating GP practice.

Indicator denominators, exclusions and personalised care adjustments (PCAs)

Indicator denominators are the numbers of patients from the appropriate disease register who are counted for QOF achievement against a specific QOF indicator.

Indicator numerator is the number of those in the denominator who meet the specific indicator success criteria.

Differences between an indicator denominator and the number on a register can be due to indicator definition.

Patients who are on the disease register, but not included in the indicator denominator for definitional reasons, are referred to as exclusions. Some indicators refer to subsets of patients on a disease register e.g. they may only refer to patients who smoke. In this instance, any non-smoking patient on the disease register is excluded.

Differences between an indicator denominator and the number on a register not due to indicator definition, but rather due to individual circumstances, are referred to as PCAs. PCAs relate to patients who are on the disease register, and who would ordinarily be included in the indicator denominator. However, they are omitted from the indicator denominator because they meet at least one of the specified PCA criteria (these are detailed under 'Background to PCA reporting').

The normal relationship between registers, denominators, exclusions and PCAs is therefore:

Register = Denominator + Exclusions + PCAs


QOF achievement data

Reference to ‘QOF achievement’ often refers to the percentage of available QOF points achieved. If a GP practice achieves the full QOF points, it has achieved 100% of the points available and may be said to have 100% achievement across the whole QOF.

The level of achievement for certain elements of QOF can be expressed in the same way. A GP practice achieving all QOF points available for indicators in the clinical domain can be said to have 100% clinical achievement even though it may not have 100% achievement overall.

GP practices achieve the maximum QOF points for most indicators (especially clinical indicators) when they have delivered the maximum threshold to achieve the points available.

For many indicators, a GP practice must provide a certain level of clinical care to 90% of patients on a specific clinical register to achieve the maximum points.

Underlying achievement (net of PCAs)

Underlying achievement (net of PCAs) data is provided in the spreadsheets associated with the report. Since a GP practice can deliver the required care to fewer than 100% of its patients (often around 90%) to achieve the full (100%) points available, there is an important distinction between percentage achievement in terms of QOF points available and the underlying achievement (net of PCAs) for specific indicators.

Underlying achievement (net of PCAs) presents the indicator numerator as a percentage of the denominator and is calculated as:

Underlying achievement net of PCAs = (Indicator numerator / Indicator denominator) * 100

 

Percentage of patients receiving the intervention

Underlying achievement (net of PCAs) does not account for all patients covered by an indicator, as it takes no account of “PCAs” (patients to whom the indicator applies, but who are not included in the indicator denominator according to agreed PCA criteria). 

Percentage of patients receiving the intervention gives a more accurate indication of the rate of the provision of interventions as the denominator for this measure covers all patients the indicator applies to, regardless of PCA status (i.e. indicator PCAs and indicator denominator). This measure is calculated as follows:

Percentage of patients receiving the intervention = (Indicator numerator /  (Indicator denominator + indicator PCAs)) * 100          

Percentage of patients receiving the intervention figures are not covered in the main report, but are presented in the excel tables at national, regional, STP, CCG and GP practice level.

Points achieved as a percentage of QOF points available

It is not always possible for GP practices to achieve all the points available in QOF. Therefore, NHS Digital produces a further measure of GP practice achievement. This measure takes account of instances where GP practices cannot achieve points because they have no patients relevant to an indicator and can be found in the achievement tables at GP practice level.

For example: if in a given financial year there are 559 QOF points available and 45 of these points are for asthma indicators but the 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 other points available they would only be able to attain 91.9% overall achievement (points achieved / points available) * 100.

In these circumstances, the standard ‘points achievement’ measure may not be representative 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: if in a given financial year there are 559 QOF points available and 45 of these points are for asthma indicators but the GP practice does not have patients on their asthma register then points available would be QOF points available minus the ‘unachievable’ 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 achievement = (Points achieved / All QOF points)  * 100

91.9% = (514 / 559)  * 100

Points achieved as percentage of QOF points available = (Points achieved / QOF points available)  * 100

100% = (514 / 514)  * 100

'Points achieved as a percentage of QOF points available’ figures are calculated for overall achievement and can be found in the achievement tables.


QOF prevalence data

QOF registers are constructed to underpin indicators on quality of care, and they do not necessarily equate to prevalence as defined by epidemiologists.

Prevalence figures based on QOF registers may differ from prevalence figures from other sources because of coding or definitional issues. 

It is difficult to interpret year-on-year changes in the size of QOF registers, as a gradual rise in QOF prevalence could be due partly to epidemiological factors (such as an ageing population) or to increased case finding and recording. Other factors in interpreting information on specific registers include:

  • Some clinical areas have ‘resolution codes’ to reflect the nature of diseases. Others, such as the cancer register, do not.
  • Some indicator groups for which there is a disease register are based on a specific age group (see table below). Prevalence for these indicator groups is calculated using a sub-set of the patient list size relating to the equivalent age group.

Indicator groups with a disease register that are age-specific

Domain Indicator group Age group (years)
Clinical Asthma 6+
Clinical Chronic kidney disease 18+
Clinical Depression 18+
Clinical Diabetes mellitus 17+
Clinical Epilepsy 18+
Clinical Non-diabetic hyperglycaemia 18+
Clinical Osteoporosis 50+
Clinical Rheumatoid arthritis 16+
Public health Obesity 18+

Many patients are likely to suffer from co-morbidity (diagnosed with more than one clinical condition in QOF clinical domain). Robust analysis of co-morbidity is not possible using QOF data because it is collected at an aggregate level for each GP practice.

There is no patient-specific data in CQRS which captures aggregated information for each GP practice on patients with coronary heart disease and on patients with diabetes, but it is not possible to identify or analyse patients with both of those diseases.

Some disease registers have more specific definitions extending beyond a patient having a record of the relevant condition. For example, to be on the asthma register, patients need a diagnosis of asthma and a prescription for an asthma drug within the year. Full register definitions can be found in the ‘Indicator definitions’ file.

The number of patients on indicator registers in the clinical domain can be used to calculate recorded disease prevalence, expressing the number of patients on each register as a percentage of the number of patients on GP practices’ lists, as described below:

Disease prevalence = (Number of patients on clinical register / Number of patients on GP practice list) ∗ 100

Where age-specific registers are used, disease prevalence can be calculated as:

Disease prevalence = (Number of patients on clinical register / Number of patients in relevant age band on GP practice list) ∗ 100


QOF PCA data

PCA reporting rates reflect the percentage of patients who are not included when determining QOF achievement and are presented for applicable indicators in QOF. For the NHS Digital QOF publication, there is a distinction between patients who are PCA-reported, and those whose non-inclusion in an indicator denominator is for definitional reasons (‘exclusions’).

PCAs

Personalised care adjustments can be applied to patients for a number of specified reasons and are usually the result of a patient or a GP decision at a personal level.

Examples of PCAs could be patient or carer refusal of treatment, a patient cancels or does not attend a consultation appointment, or a GP’s advice that two types of medication or treatment methodology should not be administered simultaneously.

PCAs are only measured at indicator level, not condition level, as a patient could be omitted from more than one indicator within a condition but would be counted more than once if these omissions were summed.

Exclusions

These are usually due to the type of patient and can be considered as non-inclusion in a denominator due to indicator definition e.g. all men are excluded from the cervical screening indicator, which is a female only measure. This affects the denominator and is not shown in this publication.

Background to PCA reporting

Patient PCA reporting applies to those indicators in the QOF where level of achievement is determined by the percentage of patients receiving the specified level of care. The GMS 2019-20 contract Section 6: Personalised care adjustment contains the following:

“As of 1 April 2019, exception reporting is being replaced with a Personalised Care Adjustment (PCA). This will allow practices to differentiate between the following reasons for adjusting care and removing a patient from the indicator denominator:

  • unsuitability for the patient, e.g. because of medicine intolerance or allergy, or contra-indicated polypharmacy
  • patient choice, following a shared decision-making conversation
  • the patient did not respond to offers of care – recording of this will change to capture actual invitations sent to patients
  • the specific service is not available (in relation to a limited number of indicators only)
  • newly diagnosed or newly registered patients, as per existing rules.

As with exception reporting applying a PCA to the patient record will remove that patient from an indicator denominator if the QOF defined intervention has not been delivered. It will not result in patients being removed from the disease register or other target population.

The associated changes to data recording and extraction should result in a redistribution of coding work away from year-end and provide better information about why patients are not receiving interventions.

Principles when considering whether a PCA applies to an individual patient practices are reminded that:

  • the duty of care remains for all patients,
  • the decision to apply a PCA should be based on clinical judgement, informed by patient preferences, and underpinned by shared decision-making principles, with clear and auditable reasons coded or entered in free text on the patient record,
  • there should be no blanket PCAs: the relevant issues with each patient should be considered by the clinician at each level of the clinical indicator set and this decision reviewed on a regular basis.

In each case where a PCA is applied then in addition to what needs to be reported for payment purposes (in accordance with the Business Rules), the contractor should also ensure that the reason for the adjustment is fully recorded in a way that can facilitate both safe and effective patient care and audit of the patient record.

Personalisation of care can occur for the following reasons which are listed in the order in which they will be extracted in the business rules:

  1. The investigative service or secondary care service is unavailable (where relevant to the indicator).
  2. Intervention described in the indicator is clinically unsuitable.
  3. The patient has chosen not to receive the intervention described in the indicator.
  4. The patient has not responded to invitations for the intervention described in the indicator (a minimum of two invitations for the intervention in the preceding 12 months, except for the cervical screening indicators.where women should receive a total of three invitations for screening).
  5. The patient has registered with the practice or has been newly diagnosed with the condition of interest in the preceding 3 months and has not received the defined clinical measurements e.g. blood pressure measurement.
  6. The patient has registered with the practice or has been newly diagnosed with the condition of interest in the preceding 9 months and has not achieved the defined clinical standards e.g. blood pressure control within target levels.

It is recognised that patients may meet more than one of these criteria and in these circumstances all reasons for PCA should be recorded in the patient’s record. However, as a patient can only be acknowledged as having a PCA once within the Business Rules for a given indicator, they will be allocated to the first criterion they meet in the hierarchy listed above. For example, where a patient is recorded as having registered with the practice in the preceding 3 months and has also chosen not to receive the intervention described in the indicator they would be identified in the Business Rules as having chosen not to receive the care.

The hierarchy listed above seeks to prioritise clinical judgement and patient choice over other criteria. Applying this hierarchy consistently in the Business Rules in conjunction with the recording changes support better attribution of the reason for care being personalised, allowing for more meaningful conversations between clinicians, commissioners, and regulators.

Calculation of PCA rates

For each indicator in the clinical domain, the PCA rate is calculated as follows:

PCA rate = (Number of PCAs  / Number of PCAs + indicator denominator) ∗ 100

The recorded number of PCAs is expressed as a percentage of the number of patients on a disease register who were qualified to be part of the indicator denominator i.e. not counted as PCAs for definitional reasons.

Manual submissions

A small number of GP practices who participate in the QOF make manual submissions to CQRS or are otherwise unable to make an electronic submission of PCA data. For this small number of GP practices, no PCA data is available. To maintain consistency with the report annexes, which are based on aggregated data from individual GP practices, they are included in the overall PCA calculations.

This has the impact of slightly reducing the PCA rates (because there are no indicator PCAs for these GP practices in the calculation numerator, but their indicator denominator data is included in the calculation denominator). The impact of this is minimal, approximately 0.8% of data submitted at GP practice level.

PCA data as extracted from CQRS

Information captured by CQRS relating to PCAs and exclusions cannot be amended on the CQRS system. CQRS is primarily a system to support QOF payments, and PCA reporting is recorded as part of that process. CQRS was not designed to deliver specific management information about PCA reporting but does allow summary information on the levels of PCA reporting to be generated. This information is the basis for this publication and is presented at GP practice level in the PRACTICE_PCA_EXCL csv.

CQRS does not allow a presentation of PCAs broken down by each of the six personalisations outlined above. There are three reasons for this:

  • CQRS uses an internal set of PCA ID codes that do not map directly into the six PCA reporting criteria in the SFE; rather, these PCA ID codes relate to PCA reporting coding ‘clusters’ in QOF business rules, often specific to individual QOF indicators. Fewer than nine of the criteria in the SFE may apply to an indicator.
  • CQRS reporting functionality does not make a distinction between PCA reporting and definitional exclusions – both types of omission from indicator denominators are included on reports available to CQRS users.

Caveats and data limitations

The CQRS system was established as a mechanism to support the calculation of GP practice QOF payments. It is not a totally comprehensive source of data on quality of care in GP practices, but it is potentially a rich and valuable source of information for healthcare organisations, analysts and researchers, providing the limitations of the data are acknowledged.

Levels of QOF achievement will be related to a variety of local circumstances and should be interpreted in the context of those circumstances. Users of the published QOF data should be particularly careful in undertaking comparative analysis.

The following points have been raised by local healthcare organisations in consultation with NHS Digital:

Prevalence and achievement

  • The ranking of GP practices based on QOF points achieved, either overall or with respect to areas within QOF, may be inappropriate. QOF points do not reflect GP practice workload issues (e.g. around list sizes and disease prevalence), that is why GP practices’ QOF payments include adjustments for such factors.
  • Comparative analysis of GP practice-level or CCG-level QOF achievement (or prevalence) may also be inappropriate without taking account of the underlying social and demographic characteristics of the populations concerned. The delivery of services may be related, for instance, to population age/sex, ethnicity or deprivation characteristics that are not included in QOF data collection processes.
  • Information on QOF achievement, as represented by QOF points, should also be interpreted with respect to local circumstances around GP practice infrastructure. In undertaking comparative or explanatory analysis, users of the data should be aware of any effect of the numbers of partners (including single handed GP practices), local recruitment and staffing issues, issues around GP practice premises, and local IT issues.
  • Users of the data should be aware that different types of GP practice may serve different communities. Comparative analysis should therefore take account of local circumstances, such as numbers on GP practice lists of student populations, drug users, homeless populations, and asylum seekers.
  • Analysis of co-morbidity (patients with more than one disease) is not possible using QOF data as it is collected at an aggregate level for each GP practice. For example, CQRS captures aggregated information for each GP practice on patients with coronary heart disease and on patients with asthma, but it is not possible to identify or analyse patients with both diseases.
  • Information held in CQRS, and the source for the published data, is dependent on diagnosis and recording (case finding) within GP practices using GP practices’ clinical information systems.
  • Measuring the quality of care is not a simple process. Within the clinical domain, QOF does not cover every clinical condition, and only describes some aspects of the care for the clinical areas that are included. However, QOF does provide valuable information (for instance on prevalence, cholesterol levels and blood pressure) on a scale unavailable before 2004-05 and provides a measure of improvement in the delivery of care.

PCAs

An important aim of QOF is to encourage appropriate and high-quality clinical care for key long-term conditions. Potentially, PCA reporting could influence the level of financial reward to GP practices.

The availability of high-level information on PCA reporting provides an indication of the variations in PCA rates that are found between specific indicators, and between NHS organisational areas.

It is also important to emphasise some of the limitations of the available data. These include GP practices missing from the analysis; the derivation of PCA counts; and the potential for amendments to indicator denominators not mirrored by changes to counts of PCAs.

Additionally, care should be taken when interpreting high level analysis in the context of local primary care service delivery, notably in terms of the numbers of patients associated with relatively high or low PCA rates. CCGs will have access to more detailed local information, and knowledge of local circumstances, to enable unusual levels of PCA reporting to be investigated further.


Comparing QOF data over time

The tables for QOF 2020-21 present data from both the current reporting year and the previous reporting year for prevalence only. Achievement and personalised care adjustment (PCA) data are not presented in the same way, as the payment protection implemented in 2020-21 means that the achievement and personalised care adjustment (PCA) data extracted for the 2020-21 reporting year could be misleading and not representative of activity undertaken. Therefore, any comparisons with data from previous years are not recommended. Further details can be found in the Guidance for GMS contract 2020/21 in England published by NHS England and NHS Improvement and GOV.UK - general medical services statement of financial entitlements (amendment) directions 2021.

The aggregated (i.e. non-GP practice level) figures presented for the previous year in this release will not match those published last year, as all figures have been recalculated using GP practice level data that can be mapped to current NHS geographies,  for those practices that participated in QOF 2020-21 only.

The definition of the Asthma register (AST005) and the Chronic obstructive pulmonary disease (COPD) register (COPD009) have changed in 2020-21, consequently the year-on-year percentage point change has not been calculated.

 


QOF formulae

Summary of formulae applied to raw QOF data

Measure Formula
Prevalence (register / number of patients on practice list) * 100
Prevalence - age-specific (register / number of patients in age band on practice list) *100
Achievement percentage (number of points achieved / 559) * 100
Maximum achievement points available sum of points available for indicators where (indicator denominator > 0) and (number PCAs for indicator denominator > 0)
Adjusted achievement percentage (number of points achieved / maximum achievement points possible) * 100
Underlying achievement score (net of PCAs) (indicator numerator / indicator denominator) * 100
Percentage of patients receiving the intervention (indicator numerator / (indicator denominator + PCAs)) * 100
PCA rate (number of PCAs / (number of PCAs + indicator denominator)) * 100

 


CSV metadata

 

ACHIEVEMENT

Data Item Description Values
PRACTICE_CODE GP practice code String (6 characters)
INDICATOR_CODE Unique code that identifies each indicator. The characters at the beginning of the string identify which group the indicator belongs to e.g. AF001 belongs to the Atrial Fibrillation group. String
MEASURE Defines the value type

ACHIEVED_POINTS

REGISTER

NUMERATOR

DENOMINATOR

PCAS

VALUE Count of the measure Numeric (Integer)

 

MAPPING_INDICATORS

Data Item Description Values
INDICATOR_CODE Unique code that identifies each indicator. The characters at the beginning of the string identify which group the indicator belongs to e.g. AF001 belongs to the Atrial Fibrillation group. String
INDICATOR_POINT_VALUE Number of points a practice gains from achieving the indicator requirements. Numeric (Integer)
GROUP_CODE Diagnostic or disease group code to which an  indicator(s) belongs. String
GROUP_DESCRIPTION Diagnostic or disease group description to which an  indicator(s) belongs. String
DOMAIN_CODE Domain code to which a  group or groups belong. String
DOMAIN_DESCRIPTION Domain description to which a  group or groups belong. Clinical
Public Health 
Quality Improvement
PATIENT_LIST_TYPE A defined age groups against which an indicator is measured. TOTAL = All ages
06OV = aged 6 and over
15OV = aged 15 and over
16OV = aged 16 and over
17OV = aged 17 and over
18OV = aged 18 and over

MAPPING_NHS_GEOGRAPHIES

Data Item Description Values
NAT_ONS_CODE Country Office of National Statistics code -  nine-character GSS code. E92000001
NAT_CODE Country code. ENG
COUNTRY Name of country. England
REGION_ODS_CODE Commissioning Region Organisational Data Service code - is a unique code created by the Organisation Data Service within NHS Digital, and used to identify organisations across health and social care. String
REGION_ONS_CODE Commissioning Region Office of National Statistics code -  nine-character GSS code. String (9 characters)
REGION_NAME Commissioning Region name. String
STP_ODS_CODE Sustainability and Transformation Partnership Organisational Data Service code - is a unique code created by the Organisation Data Service within NHS Digital, and used to identify organisations across health and social care. String
STP_ONS_CODE Sustainability and Transformation Partnership Office of National Statistics code -  nine-character GSS code. String (9 characters)
STP_NAME Sustainability and Transformation Partnership name. String
CCG_ODS_CODE Clinical Commissioning Group Organisational Data Service code - is a unique code created by the Organisation Data Service within NHS Digital, and used to identify organisations across health and social care. String
CCG_ONS_CODE Clinical Commissioning Group Office of National Statistics code -  nine-character GSS code. String (9 characters)
CCG_NAME Clinical Commissioning Group name. String
PCN_ODS_CODE Primary Care Network Organisational Data Service code - is a unique code created by the Organisation Data Service within NHS Digital, and used to identify organisations across health and social care. There is no ONS equivalent. String
PCN_NAME Primary Care Network name. String
PRACTICE_CODE GP practice code. String (6 characters)
PRACTICE_NAME GP practice name. String

 

MAP_PCAS_EXCL_CAT_TO_INDICATOR

Data Item Description Values
INDICATOR_CODE Unique code that identifies each indicator. The characters at the beginning of the string identify which group the indicator belongs to e.g. AF001 belongs to the Atrial Fibrillation group. String
PCA_EXCL_NAME Name of the PCA or Exclusion String
PCA_EXCL_SHORT_NAME Shortened name of the PCA or Exclusion String
PCA_EXCL_DESCRIPTION Full description of the PCA or Exclusion String
TYPE Personalised Care Adjustment or Exclusion PCA = (Personalised Care Adjustment) differences between an indicator denominator and the number on a register not due to indicator definition, but rather due to individual circumstances
Exclusion = Patients who are on the disease register, but not included in the indicator denominator for definitional reasons.
GENERAL_SPECIFIC Applies to PCAs only and indicates if the PCA is used across indicators or is specific to an indicator. General = applied to several indicators across the groups
Specific = applied to a specific indicator
n/a = does not apply to exclusions
PCA_CATEGORY  Category which prompted the patient's omission - more information can be found in the Technical Annex. 0 = is used to signify an Exclusion. This enables the numeric values to be sorted.
All other values 1 to 6 signify the order in which the PCAs are applied.
 
PCA_CATEGORY_DESCRIPTION Full description of the PCA category. String

 

ORGANISATION_REFERENCE

Data Item Description Values
PRACTICE_CODE Unique code that identifies each indicator. The characters at the beginning of the string identify which group the indicator belongs to e.g. AF001 belongs to the Atrial Fibrillation group. String (6 characters)
REVISED_MAXIMUM_POINTS Maximum points it is possible for a practice to achieve. This may be different from the maximum points available as a practice may be part of local QOF arrangements - more information can be found in the Technical Annex. Numeric (Integer)

 

PRACTICE_PCA_EXCL

Data Item Description Values
PRACTICE_CODE GP practice code String (6 characters)
INDICATOR_CODE Unique code that identifies each indicator. The characters at the beginning of the string identify which group the indicator belongs to e.g. AF001 belongs to the Atrial Fibrillation group. String
PCA_EXCL_NAME Name of Personal Care Adjustments or Exclusions. String
TYPE Personal Care Adjustment or Exclusion PCA = (Personal Care Adjustment) differences between an indicator denominator and the number on a register not due to indicator definition, but rather due to individual circumstances
Exclusion = Patients who are on the disease register, but not included in the indicator denominator for definitional reasons.
COUNT Number of PCAs or Exclusions Numeric (Integer)

 

PRACTICE_VALIDATION_OUTCOMES

Data Item Description Values
PRACTICE_CODE GP practice code String (6 characters)
VALIDATION_RULE Rule which prompted the practice's omission - more information can be found in the Technical Annex. Numeric (Integer)
RULE_DESCRIPTION Short description of the validation rule, a full description can be found in the Technical Annex. String

 

PREVALENCE

Data Item Description Values
PRACTICE_CODE GP practice code String (6 characters)
GROUP_CODE Disease group code to which an  indicator r indicators belongs. Does not include the following groups as they do not contain registers: Smoking (SMOK);  Blood Pressure (BP); Cervical Screening (CS); Non-diabetic Hyperglycaemia (NDH); Early Cancer Diagnosis (QIECD) and Care of people with Learning Disabilities.
REGISTER Patients on an indicator group register Numeric (Integer)
PATIENT_LIST_TYPE A defined age groups against which an indicator is measured. TOTAL = All ages
06OV = aged 6 and over
15OV = aged 15 and over
16OV = aged 16 and over
17OV = aged 17 and over
18OV = aged 18 and over
PRACTICE_LIST_SIZE Patients registered at a GP practice Numeric (Integer)


Last edited: 1 October 2021 12:45 pm