Quality and Outcomes Framework monies for GP practices – what’s protected?

Quality and Outcomes Framework monies for GP practices – what’s protected?

Many GP practices are reporting confusion about 20/21 Quality and Outcomes Framework (QOF) monies, as their QOF achievement reports show lower earnings than they were expecting. So why is this?

2019/20

Let’s first go back to 2019/20. The Quality and Outcomes Framework year was largely over by the time the COVID-19 pandemic hit the UK. NHS England agreed to top up monies for that year, where 2019/20 earnings were less than those in the 2018/19 year as a result of the pandemic. Therefore, QOF income was fully protected.

2019/20 Quality and Outcomes Framework monies were based on a maximum of 559 points at £187.74 per point (before adjusting for list size and disease prevalence).

2020/21

For the 2020/21 year, 567 points were available at £194.83 per point.

The 2020/21 General Medical Services (GMS) contract guidance suggested that some indicators would continue to be based on practice performance, worth up to 257 points, with the remaining 310 points protected on the basis of historical practice performance and agreement with the Clinical Commissioning Group (CCG).

However, further guidance by the British Medical Association (BMA) stated that only 139 points would be based on actual 2020/21 achievement; 74 points would be awarded in full; and the remaining 354 points would be based on previous achievement.

Of the 354 points based on previous achievement, most of the indicators would be protected based on 2018/19 achievement levels (at 2020/21 QOF point value). For the 80 points new for the 2019/20 year, protection would be based on 2019/20 achievement.

To further confuse matters, we understand that Mid and South Essex CCG member practices have recently received communication from the CCG indicating that some practices had received 20/21 QOF Reports which did not reflect the CCG’s commitment to protect practices’ QOF income for 20/21. They have said they will provide additional QOF monies for practices that achieved a higher QOF income in 2019/20 than in 2018/19.

2021/22

What can we expect for 2021/22?

• An increase in total points to 635 to reflect the increased number of domains incorporated within the QOF, with a QOF point being worth £201.16.
• The existing indicators are largely the same as the 2020/21 year, and full QOF activity is expected to have recommenced from April 2021.

How can I check my achievement is as expected?

You should be able to run an achievement summary report for 2019/20 and 2018/19 in CQRS to validate performance for those years. You can compare them with the achievement for 2020/21 to check the protected domains are as expected.

If you require any assistance with this, please get in touch with your usual contact within the Larking Gowen Medical Team and we would be happy to look at this with you. You can find details on the Our People section of our website. Alternatively, call 0330 024 0888 or email enquiry@larking-gowen.co.uk

Emma Wood