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Quality Outcomes Framework (QOF) frequently asked questions (FAQs) 2019/20

This page features frequently asked questions (FAQs) about the Quality Outcomes Framework (QOF) 2019/20.

What is the national average practice list size that will be used in the re-calculations for QOF 2019/20 achievement?

The national average practice list size as of 1 January 2020 is 8799

The national average practice list size as of 1 January 2019 is 8479

The national average practice list size as of 1 January 2018 is 8096

What is the value of a QOF point?

The value of a QOF point for 2020/21 is £194.83

The value of a QOF point for 2019/20 is £187.74

The value of a QOF point for 2018/29 is £179.26

The value of a QOF point for 2017/18 is £171.20

How will GP Practices be paid for QOF 2019/20?

GP practice payments for QOF 2019/20 achievement and QOF 2020/21 monthly aspiration are expected to be paid in the usual way.

Which manual indicators do I need to complete on CQRS?

Manual entry is required for the following four indicators before midnight on the 31 March 2020:

  • QI001
  • QI002
  • QI003
  • QI004

These indicators cannot be extracted automatically from your GP clinical systems. QOF achievement will only calculate if these four indicators have been completed.
For a step by step guide, refer to the Required Manual Indicators user guide available on our website.

Do I have to manually enter all data for QOF?

Practices that need to manually enter QOF information include:

  • shared practices: practices sharing a clinical system need to separately enter their achievement manually as CQRS only collects automatically for one practice
  • closing practices: practices closing before the end of the financial year need to enter QOF achievement information manually into CQRS. Data must be entered up to the date that they close
  • others: practices that cannot have information collected automatically for other reasons need to enter QOF achievement information into
    CQRS manually

A guide on how to manually enter the full set of QOF indicators will be available on the QOF page.

What is required if a GP practice is closing before 31 March 2020?

If your GP practice is closing before the 31 March 2020 please perform the following actions:

  1. Check the GP practice closure date on CQRS. If it is not correct, contact your commissioning organisation, who will need to update this via PCSE. If it has been updated, raise a call with the CQRS Service Desk.
  2. Check that your participation in QOF 2019/20 ends on the same date that your GP practice closes. If not, raise a call with the CQRS Service Desk.

  3. Manually enter data for QOF 2019/20. Ensure that you set the date in CQRS for the period that you are entering data for. This should be the same as the practice closure date.

What do I need to do if a GP practice is merging or splitting before 31 March 2020?

CQRS does not have the information to correctly calculate QOF achievement for the merged or split section of a GP practice.

CQRS will calculate QOF 2019/20 as if the GP practice has not undergone a split or merge.

Your commissioning organisation will need to manually determine the impact of the merge/split on the QOF payments and apply these through the NHAIS/Exeter system.

A Provider Post Achievement Modelling tool is available on CQRS to assist with this process.

What do I need to do if a practice is closing, merging or splitting on the 31 March 2020 or from the 1 April 2020?

Check with your GP practice system supplier to investigate if they will be sending an automated QOF extract for your practice for the 31 March 2020 that will correctly reflect the state of your GP practice before the closure, split or merge. If an automated collection is being sent, no further actions are required beyond the standard year-end actions.

If an automated extract will not be supplied by your GP practice system supplier, you will need to manually enter your QOF 2019/20 data.

For a step by step guide, refer to the Full Manual Entry Guide on our website.

What do I need to do for QOF if I am part of a shared practice?

Where more than one GP practice has been set up on a single instance of a clinical system and the clinical system supplier cannot produce separate QOF extracts for each GP practice, the GP practice is required to manually enter its data onto CQRS.

For a step by step guide, refer to the full user guide on our website.

Is the Commissioning Organisation required to sign off QOF aspiration payments?

No. The aspiration payment for any practices that we have achievement data for will be calculated following the QOF 2019/20 calculation and release of payment files. The exact payment date will depend on local arrangements.

How will I know if I will receive my estimated QOF aspiration payment?

In total there are five possible scenarios:

Standard aspiration payments

The following two scenarios will receive the standard aspiration payment for QOF 2020/21:

  1. Practices where automated data is available and the four required manual indicators have been entered.
  2. Practices who have been advised to manually enter all QOF indicators and have manually entered this data.

Estimated aspiration payments

The remaining three scenarios will receive an estimated aspiration payment for QOF 2020/21:

  1. Practices where automated data is available from GPES, but the four required indicators have not been manually entered.
  2. Practices where the automated data is not available for the year end extract from GPES but have entered data for the four required manual indicators.
  3. Practices for which no data is available, from GPES or manual.

Once all QOF 2019/20 data is supplied, the standard aspiration will be calculated, and an adjustment made.

What happens to aspiration payments for practices that have merged?

Before undertaking any action, contact your commissioning organisation for advice – they may have an established process in place.

There is some reconciliation work required to ensure that practices are paid the appropriate aspiration which takes into account the QOF achievement for patients that merged into the practice during the QOF year.

Updated CRP figures should be provided to NHSD so that CQRS can be updated to reflect the new practice list size including the merged patients.

Option 1 – automated extract and calculation with subsequent reconciliation

You can let it calculate through year-end and reconcile afterwards:

  • provide updated CRP figures to NHSD so that CQRS can be updated to reflect the new practice list size including the merged patients
  • the extract for QOF year-end 19/20 will produce an interim achievement figure – this will be an inflated figure as it includes the new patients. Do not declare this figure
  • CQRS will calculate an interim aspiration figure – this will also be an inflated figure. This will not be paid until the achievement figure is declared
  • the practice will then get a balancing figure for 19/20 achievement
  • the practice will need to go through and balance the achievement by checking each indicator and removing the counts for the patients that belonged to the closed up to the closing date of the practice
  • once the counts for the patients that belong to the closed practice have been removed, the practice can evidence this to the commissioning organisation and declare the achievement
  • there will be an adjustment figure for QOF 19/20 achievement that will come via NHAIS
  • there will then be a balancing figure for 20/21 aspiration that will also come via NHAIS
  • aspiration payments will then be adjusted for the rest of the financial year to ensure that the right amount is paid – likely to be less than the initial payments

Option 2 – manually enter and declare QOF for each practice by 31 March 2020

Each practice could manually enter and declare their own QOF based on their achievement. This would need to be submitted and financially approved before 31 March. If it wasn’t financially declared by 31 March, the automated extract would overwrite anything that had been input. If declared and approved by 31 March, Aspiration would then be calculated on this figure and it wouldn’t be necessary to reconcile or balance any payments.

How do I review my QOF 2019/20 achievement data on CQRS?

From the 5 April you will be able to:

  • log in to CQRS
  • select the Reports Tab (it should default to Achievement)
  • select the report Achievement Summary

Then, select the parameters:

  • select the Financial Year option and set to 2019/20
  • select the Quality Service option and set to Quality and Outcomes Framework 2019/20
  • select the option to Run Report

The QOF 2019/20 achievement data for your GP practice should then be displayed. Initially this will show the clinical and public health domains, the total achievement and any adjustments for PMS contracts, CPI calculation and Contract duration. You can then access further information within each domain, (for example Clinical) by clicking on it. This will display the Indicator Groups. Clicking in each of the indicators will display further information, including how the QOF achievement has been calculated.

What reports are available on CQRS to help with QOF 2019/20?

A full list of reports is available on the GP Collections website under the Reporting section.

Two reports are available for commissioners under the Data Entry tab.

1. Data Entry Quality Service Data Complete

  • select the Quality Service 'QOF 19/20' and click Run Report
  • the report will list all GP practices within your commissioning area who are participating in QOF 2019/20 and have completed their manual indicators

2. Data Entry Quality Service Data Missing

  • select the Quality Service 'QOF 19/20' and click Run Report
  • the report will list all GP practices within your commissioning area that are participating in QOF 2019/20 but have not completed their manual indicators

When will I see QOF 2019/20 achievement data in CQRS?

Achievement data will start becoming visible in CQRS from 5 April 2020. Some practices may see this data a few days later if their data is collected via additional extractions.

In line with previous years, once the achievement payment has been approved, CQRS will adjust the standard aspiration as required to reflect the actual QOF 2019/20 achievement.

Is there a deadline for declaring QOF 2019/20 data in CQRS?

There is no specific deadline enforced by CQRS. The Statement of Financial Entitlement (SFE) states that the date for declaration should be by the end of June, but can be extended if the achievement data is in dispute between the GP practice and the commissioning organisation.

What should a GP practice do if they don’t agree with the achievement data they see in CQRS?

If your practice disagrees with the achievement payment values calculated in CQRS:

  • assemble evidence in support of the disagreement and inform your commissioning organisation
  • if the numerator, denominator or exceptions are incorrect, contact your GP system supplier and obtain the relevant evidence
  • provide full evidence to your commissioning organisation. They will be required to review the evidence and negotiate an adjustment

NHS Digital cannot resolve disputes or update your data in CQRS. Amendments to data as a result of disputes and queries are actioned by your commissioning organisation.

I have calculated the QOF figure for my practice outside of the CQRS system – is the CQRS figure incorrect?

The calculated figure is based on the data extracted from your GP system. The calculation in CQRS is rigorously tested and we are confident that the calculation method is correct. If it is not what you are expecting to see, then you need to query this with your GP system supplier in the first instance.

The calculation includes a number of factors, so it is unlikely that a locally calculated figure will match the figure in the system.

Indicator calculation

Actual achievement / Maximum potential achievement x Points available for indicator x Value of a QOF point x Adjustment prevalence (patient set/CRP) / National prevalence (average prevalence)

 

Will a GP practice need to retain clinical system audit reports of the final QOF achievement submission reports?

GPs are encouraged to retain clinical system audit reports. This supports any post verification work and assists reconciliation against the final CQRS report. CQRS will retain QOF data for five years.

Where is all the guidance documentation kept?

All guidance documentation can be found on the QOF page.

Last edited: 28 February 2020 5:54 pm