Revisions to QOF Clinical Points 2006

© Martin Breach

Haydock Medical Centre

List of all UK GP GMS QOF quality point changes and revisions 2006, with altered quality points and changed % scores and percent targets

Secondary Prevention of Coronary Heart Disease

 

Indicator

Points 2004-5

Points

Payment Stages

Max % score

2004-5

Records

 

 

 

 

CHD 1. The practice can produce a register of patients with coronary heart disease

6

4

 

 

Diagnosis and initial management

 

 

 

 

CHD 2. The percentage of patients with newly diagnosed angina (diagnosed after 1 April 2003) who are referred for exercise testing and/or specialist assessment

 

7

40–90%

 

Ongoing Management

 

 

 

 

Smoking (CVD 3 and CVD4) removed to new domain

CHD 5. The percentage of patients with coronary heart disease whose notes have a record of blood pressure in the previous 15 months

 

 

 

 

7

 

 

 

40-90%

 

CHD 6. The percentage of patients with coronary heart disease in whom the last blood pressure reading (measured in the previous 15 months) is 150/90 or less

 

19

40-70%

 

CHD 7. The percentage of patients with coronary heart disease whose notes have a record of total cholesterol in the previous 15 months

 

7

40-90%

 

CHD 8. The percentage of patients with coronary heart disease whose last measured total cholesterol (measured in the previous 15 months) is 5 mmol/l or less

16

17

40-70%

60%

CHD 9. The percentage of patients with coronary heart disease with a record in the previous 15 months that aspirin, an alternative anti-platelet therapy, or an anti-coagulant is being taken (unless a contraindication or side-effects are recorded)

 

7

40-90%

 

CHD 10. The percentage of patients with coronary heart disease who are currently treated with a beta blocker (unless a contraindication or side-effects are recorded)

 

7

40-60%

50%

CHD 11. The percentage of patients with a history of myocardial infarction (diagnosed after 1 April 2003) who are currently treated with an ACE inhibitor or Angiotensin II antagonist

 

7

40-80%

70%

CHD 12. The percentage of patients with coronary heart disease who have a record of influenza immunisation in the preceding 1 September to 31 March

 

7

40-90%

85%


Heart Failure
(replaces left ventricular dysfunction)

Indicator

 

Points

Payment Stages

 

Records

 

 

 

 

HF1: The practice can produce a register of patients with heart failure.

 

4

 

 

Initial diagnosis

 

 

 

 

HF2: The percentage of patients with a diagnosis of heart failure (diagnosed after 1 April 2006) which has been confirmed by an echocardiogram or by specialist assessment.

 

6

40-90%

 

Ongoing management

 

 

 

 

HF3: The percentage of patients with a current diagnosis of heart failure due to LVD who are currently treated with an ACE inhibitor or Angiotensin Receptor Blocker, who can tolerate therapy and for whom there is no contra-indication.

 

10

40-80%

70%

 


 


Stroke and TIA

Indicator

 

Points

Payment Stages

Records

 

 

 

STROKE 1. The practice can produce a register of patients with Stroke or TIA

4

2

 

STROKE 11. The percentage of new patients with a stroke who have been referred for further investigation.

 

2

40-80%

Ongoing Management

 

 

 

 

Smoking (Stroke 3 and Stroke 4) removed to new domain

 

STROKE 5. The percentage of patients with TIA or stroke who have a record of blood pressure in the notes in the preceding 15 months

 

 

 

 

 

2

 

 

 

 

40-90%

STROKE 6. The percentage of patients with a history of TIA or stroke in whom the last blood pressure reading (measured in the previous 15 months) is 150/90 or less

 

5

40-70%

STROKE 7. The percentage of patients with TIA or stroke who have a record of total cholesterol in the last 15 months

 

2

40-90%

STROKE 8. The percentage of patients with TIA or stroke whose last measured total cholesterol (measured in the previous 15 months) is 5 mmol/l or less

 

5

40-60%

STROKE 12. The percentage of patients with a stroke shown to be non-haemorrhagic, or a history of TIA, who have a record that an anti-platelet agent (aspirin, clopidogrel, dipyridamole or a combination), or an anti-coagulant is being taken (unless a contraindication or side-effects are recorded)

 

4

40-90%

STROKE 10. The percentage of patients with TIA or stroke who have had influenza immunisation in the preceding 1 September to 31 March

 

2

40-85%

 


 


Hypertension

Indicator

 

Points

Payment Stages

Records

 

 

 

BP 1. The practice can produce a register of patients with established hypertension

9

6

 

Ongoing Management

 

 

 

 

Smoking (BP 2 and BP 3) removed to new domain

 

BP 4. The percentage of patients with hypertension in whom there is a record of the blood pressure in the previous 9 months

 

 

 

 

20

 

 

 

40-90%

BP 5. The percentage of patients with hypertension in whom the last blood pressure (measured in the previous 9 months) is 150/90 or less

56

57

40-70%

 


 


Diabetes Mellitus

Indicator

 

Points

Payment

 Stages

 

Records

 

 

 

 

DM 19.The practice can produce a register of all patients aged 17 years and over with diabetes mellitus, which specifies whether the patient has Type 1 or Type 2 diabetes.

 

6

 

 

Ongoing Management

 

 

 

 

DM 2.The percentage of patients with diabetes whose notes record BMI in the previous 15 months

 

Smoking (DM 3 and DM 4) removed to new domain

 

3

40-90%

 

DM 5. The percentage of diabetic patients who have a record of HbA1c or equivalent in the previous 15 months

 

3

40-90%

 

DM 20. The percentage of patients with diabetes in whom the last HbA1c is 7.5 (7.4) or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months

16

17

40-50%

 

DM 7. The percentage of patients with diabetes in whom the last HbA1c is 10 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months

 

11

40-90%

85%

DM 21. The percentage of patients with diabetes who have a record of retinal screening in the previous 15 months

 

5

40-90%

 

DM 9.The percentage of patients with diabetes with a record of the presence or absence of peripheral pulses in the previous 15 months

 

3

40-90%

 

DM 10. The percentage of patients with diabetes with a record of neuropathy testing in the previous 15 months

 

3

40-90%

 

DM 11. The percentage of patients with diabetes who have a record of the blood pressure in the previous 15 months

 

3

40-90%

 

DM 12. The percentage of patients with diabetes in whom the last blood pressure is 145/85 or less

17

18

40-60%

55%

DM 13. The percentage of patients with diabetes who have a record of micro-albuminuria testing in the previous 15 months (exception reporting for patients with proteinuria)

 

3

40-90%

 

DM 22. The percentage of patients with diabetes who have a record of estimated glomerular filtration rate (eGFR) or serum creatinine testing in the previous 15 months

 

3

40-90%

 

DM 15. The percentage of patients with diabetes with a diagnosis of proteinuria or micro-albuminuria who are treated with ACE inhibitors (or A2 antagonists)

 

3

40-80%

70%

DM 16. The percentage of patients with diabetes who have a record of total cholesterol in the previous 15 months

 

3

40-90%

 

DM 17. The percentage of patients with diabetes whose last measured total cholesterol within previous 15 months is 5 mmol/l or less

 

6

40-70%

60%

DM 18. The percentage of patients with diabetes who have had influenza immunisation in the preceding 1 September to 31 March.

 

3

40-85%

 

 


 


Chronic Obstructive Pulmonary Disease

COPD is diagnosed if:

• the patient has an FEV1 of less than 70% of predicted normal

• and has an FEV1/FVC ratio of less than 70%

• and there is a less than 15% response to a reversibility test.

 

All of these elements are required to make the diagnosis of COPD and to exclude

co-existing asthma. It is acknowledged that COPD and asthma can co-exist and that

many patients with asthma who smoke will eventually develop irreversible airways

obstruction. However, where asthma is present, these patients should be managed as

asthma patients as well as COPD patients.

 

While it is recognised that there may be an element of reversibility in patients with

COPD, the definition centres on the lack of reversibility.

 

·         Patients with reversible airways obstruction should be included in the asthma disease register.

·         Patients with co-existing asthma and COPD should be included on the register for both conditions.

 

Indicator

 

Points

Payment

Stages

 

 

Records

 

 

 

 

 

COPD 1. The practice can produce a register of patients with COPD

5

3

 

 

 

Initial diagnosis

 

 

 

 

 

COPD 9. The percentage of all patients with COPD in whom diagnosis has been confirmed by spirometry including reversibility testing

(previously, COPD 2 and COPD 3 distinguished between new and existing patients)

 

10

40-80%

90

 

Ongoing management

 

Smoking (COPD 4 and COPD 5) removed to new domain

 

 

 

 

 

 

COPD 10. The percentage of patients with COPD with a record of FeV1 in the previous 15 months (previously 27 months)

6

7

40-70%

 

 

COPD 11. The percentage of patients with COPD receiving inhaled treatment in whom there is a record that inhaler technique has been checked in the previous 15 months

6

7

40-90%

 

 

COPD 8. The percentage of patients with COPD who have had influenza immunisation in the preceding 1 September to 31 March

 

6

40-85%

 

 

 


 


Asthma

Indicator

 

Points

Payment

 Stages

 

Records

 

 

 

 

ASTHMA 1. The practice can produce a register of patients with asthma, excluding patients with asthma who have been prescribed no asthma-related drugs in the previous twelve months

7

4

 

 

Initial Management

 

 

 

 

ASTHMA 8. The percentage of patients aged eight and over diagnosed as having asthma from 1 April 2006 with measures of variability or reversibility (previously, confirmed by spirometry or PEF measurement)

 

15

40-80%

70%

Ongoing management

 

 

 

 

ASTHMA 3. The percentage of patients with asthma between the ages of 14 and 19 in whom there is a record of smoking status in the previous 15 months

 

Smoking (ASTHMA 4 and 5) is now removed

 

 

6

40-80%

70%

ASTHMA 6. The percentage of patients with asthma who have had an asthma review in the previous 15 months

 

20

40-70%

 

 

ASTHMA 7, flu vaccination in patients with asthma in previous 12 months, previously worth 12 points, is now removed


 


Epilepsy

Indicator

 

Points

Payment Stages

Records

 

 

 

EPILEPSY 5. The practice can produce a register of patients aged 18 and over receiving drug treatment for epilepsy

2

1

 

Ongoing management

 

 

 

EPILEPSY 6. The percentage of patients age 18 (previously 16) and over on drug treatment for epilepsy who have a record of seizure frequency in the previous 15 months

 

4

40-90%

EPILEPSY 7. The percentage of patients age 18 (previously 16) and over on drug treatment for epilepsy who have a record of medication review involving the patient and/or carer in the previous 15 months

 

4

40-90%

EPILEPSY 8. The percentage of patients age 18 (previously 16) and over on drug treatment for epilepsy who have been seizure free for the last 12 months recorded in the previous 15 months

 

6

40-70%

 


 


Hypothyroid

Indicator

 

Points

Payment Stages

Records

 

 

 

THYROID 1. The practice can produce a register of patients with hypothyroidism

2

1

 

Ongoing management

 

 

 

THYROID 2. The percentage of patients with hypothyroidism with thyroid function tests recorded in the previous 15 months

 

6

40-90%

 


 


Cancer

Indicator

 

Points

Payment Stages

Records

 

 

 

CANCER 1. The practice can produce a register of all cancer patients defined as a ‘register of patients with a diagnosis of cancer excluding non-melanotic skin cancers from 1 April 2003

6

5

 

Ongoing management

 

 

 

CANCER 3. The percentage of patients with cancer, diagnosed within the last 18 months who have a patient review recorded as occurring within 6 months of the practice receiving confirmation of the diagnosis

 

6

40-90%





 

Mental Health

Indicator

 

Points

Payment Stages

Records

 

 

 

MH 8. The practice can produce a register of people with schizophrenia, bipolar disorder and other psychoses (previously, long term mental health problems)

7

4

 

Ongoing management

 

 

 

MH 9. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses with a review recorded in the preceding 15 months. In the review there should be evidence that the patient has been offered routine health promotion and prevention advice appropriate to their age, gender and health status

 

23

40-90%

MH 4. The percentage of patients on lithium therapy with a record of serum creatinine and TSH in the preceding 15 months

3

1

40-90%

MH 5. The percentage of patients on lithium therapy with a record of lithium levels in the therapeutic range within the previous 6 months

8

2

40-90%

MH6: The percentage of patients on the register who have a comprehensive care plan documented in the records agreed between individuals, their family and/or carers as appropriate

 

6

25-50%

MH7: The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who do not attend the practice for their annual review who are identified and followed up by the practice team within 14 days of non-attendance

 

3

40-90%




 

Dementia (new for 2006)

Indicator

Points

Payment Stages

Records

 

 

DEM1: The practice can produce a register of patients diagnosed with dementia

5

 

Ongoing management

 

 

DEM2: The percentage of patients diagnosed with dementia whose care has been reviewed in the previous 15 months

15

 25-60%




 

Depression (new for 2006)

Indicator

Points

Payment Stages

Diagnosis and initial management

 

 

DEP1: The percentage of patients on the diabetes register and /or the CHD register for whom case finding for depression has been undertaken on one occasion during the previous 15 months using two standard screening questions

 

During the last month, have you often been bothered by feeling down, depressed or hopeless?

 

and

 

During the last month, have you often been bothered by having little interest or pleasure in doing things?”

 

8

40-90%

DEP2: In those patients with a new diagnosis of depression, recorded between the preceding 1 April to 31 March, the percentage of patients who have had an assessment of severity at the outset of treatment using an assessment tool validated for use in primary care

25

40-90%


The three suggested severity measures validated for use in a primary care setting are the

         Patient Health Questionnaire (PHQ-9)

         Beck Depression Inventory Second Edition (BDI-II)

         Hospital Anxiety and Depression Scale (HADS).

It is advisable for a practice to choose one of these three measures and become familiar with its questions and scoring systems.

The PHQ-9 is a nine question self-report measure of severity and can be downloaded free of charge from:

www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9/questionnaire/  

The HADS is a 7 question scale and can be purchased (£41.50 for 100) from www.onestopeducation.co.uk/icat/hospitalanxietyanddepress

The Beck is a 21-item scale and can be purchased (£36 for 25) from

www.harcourt-uk.com/

Whichever method is used, the scoring must be done within 1 month of diagnosis (ie the date of coding of depression on your system)




 

Chronic Kidney Disease (new for 2006)

Indicator

Points

Payment Stages

Records

 

 

CKD1: The practice can produce a register of patients aged 18 years and over with CKD (US National Kidney Foundation: Stage 3 to 5 CKD)

6

 

Initial Management

 

 

CKD2: The percentage of patients on the CKD register whose notes have a record of blood pressure in the previous 15 months

6

40-90%

Ongoing Management

 

 

CKD3: The percentage of patients on the CKD register in whom the last blood pressure reading, measured in the previous 15 months, is 140/85 or less

11

40-70%

CKD4: The percentage of patients on the CKD register with hypertension who are treated with an angiotensin converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) (unless a contraindication or side effects are recorded)

4

40-80%

 

CKD info

Chronic Kidney Disease guidelines for Primary Care

http://www.swtirr.org.uk/st_helier_renal_guidelines_gp_jan_06.pdf

 

eGFR: Frequently asked questions

http://www.renal.org/eGFR/resources/eGFRFAQs020306.doc



Atrial Fibrillation (new for 2006)

Indicator

Points

Payment Stages

Records

 

 

AF1: The practice can produce a register of patients with atrial fibrillation.

5

 

Initial diagnosis

 

 

AF2: The percentage of patients with atrial fibrillation diagnosed after 1 April 2006 with ECG or specialist confirmed diagnosis.

10

40-90%

Ongoing Management

 

 

AF3: The percentage of patients with atrial fibrillation who are currently treated with anti-coagulation drug therapy or an anti-platelet therapy.

15

40-90%




 

Obesity

Indicator

Points

 

Records

 

 

OB1: The practice can produce a register of patients aged 16 and over with a BMI greater than or equal to 30 in the previous 15 months.

8

 




 

Learning Disabilities

Indicator

Points

 

Records

 

 

The practice can produce a register of patients with learning disabilities

4

 




 

Smoking Indicators

Indicator

 

Points

Payment Stages

Ongoing management

 

 

 

Smoking 1: The percentage of patients with any or any combination of the following conditions: coronary heart disease, stroke or TIA, hypertension, diabetes, COPD or asthma whose notes record smoking status in the previous 15 months. Except those who have never smoked where smoking status need only be recorded once since diagnosis

35

33

40-90%

Smoking 2: The percentage of patients with any or any combination of the following conditions: coronary heart disease, stroke or TIA, hypertension, diabetes, COPD or asthma who smoke whose notes contain a record that smoking cessation advice or referral to a specialist service, where available, has been offered within the previous 15 months

33

35

40-90%

 


 

Palliative Care (new for 2006)

Indicator

Points

Payment Stages

Records

 

 

PC1: The practice has a complete register available of all patients in need of palliative care/support.

3

 

Ongoing management

 

 

PC2: The practice has regular (at least 3 monthly) multidisciplinary case review meetings where all patients on the palliative care register are discussed.

3