QOF: Highlighting the Key Clinical Changes

Are you up to date on the latest clinical changes in the Quality and Outcomes Framework (QOF)? Designed to incentivise primary care practices to improve the quality of care they provide to patients, QOF has recently undergone some key clinical changes. For pharmacists, it's essential to stay informed about the latest requirements to ensure you can continue to support your patients and your practice effectively. Inspired by our recent podcast, we have put together a short article which highlights these key clinical changes for pharmacists.

1. Cholesterol Control and Lipid Management (CHOL)

The first significant change is the two new indicators which have been added to Cholesterol Control and Lipid Management, CHOL001 and CHOL002.

CHOL001

• This new indicator is the percentage of patients on the QOF Coronary Heart Disease, Peripheral Arterial Disease, Stroke/TIA or Chronic Kidney Disease Register who are currently prescribed a statin.
• This indicator will carry 14 points with a lower threshold target of 70% and an upper threshold target of 95%.
• This new indicator means that if a statin is declined or clinically unsuitable, patients will now need to be offered another lipid lowering therapy. Previously, indicators only focused on statins, but now pharmacists will have a new pathway for managing cholesterol in patients who cannot tolerate statins. This development will help encourage pharmacists to consider all options for their patients.

CHOL002

• This new indicator is the percentage of patients on the QOF Coronary Heart Disease, Peripheral Arterial Disease, or Stroke/TIA Register, who have a recording of non-HDL cholesterol in the last 12 months that is lower than 2.5 mmol/L. Or where non-HDL cholesterol is not recorded, they have a recording of LDL cholesterol in the last 12 months that is lower than 1.8 mmol/L.
• This indicator will carry 16 points with a lower threshold target of 20% and an upper threshold target of 35%.
• This new indicator means that pharmacists need to be looking at starting statins and lipid lowering therapy as normal, but they should also now be considering intensifying therapy. It's crucial for pharmacists to be aware of this, as they will play an important part in educating their practice and assisting with its management.

2. Atrial Fibrillation (AF)

One other key clinical change worth highlighting is the change regarding Atrial Fibrillation (AF), where the indicator AF007 will now be replaced with a new indicator, the AF008 indicator.

AF008

• This indicator is the percentage of patients on the QOF Atrial Fibrillation register with a CHA2DS2-VASc score of 2 or more, who were prescribed a DOAC (direct-acting oral anticoagulant). Or, where a DOAC was declined or confirmed clinically unsuitable, a Vitamin K antagonist.
• This will carry 12 points, with a lower threshold target of 70% and upper threshold of 95%.
• It is a very similar indicator to CVD-05 from this year’s IIF (Investment and Impact Fund).
• This indicator means that pharmacists may now need to review patients who are on warfarin and consider whether prescribing a DOAC would be suitable.

In Summary

In conclusion, the new clinical changes outlined above will have a significant impact on primary care practices and the services they offer to patients. As a pharmacist, it's essential to keep up to date with the latest requirements to ensure you can provide the best possible care and support to both your patients and your practice. By understanding the changes and their implications, you can continue to play an essential role in helping primary care practices meet their QOF targets, improving patient outcomes and promoting better health in the community.

To view the full QOF guidance document, or to watch our recent podcast episode on this topic, please follow the links below.

QOF Guidance

Podcast Episode