As the country starts to prepare for the end of lockdown and the restrictions that it has brought on all of us, the NHS has published its guidelines for general practice, demonstrating the direction it believes primary care should be taking.
The Quality and Outcomes Framework (QOF) for 2021/22 will be based very much on the indicators which were agreed for the previous financial year – with a few changes.
Of course, any requirements for general practice went out of the window with the pandemic as the country struggled to adapt to the change in circumstances. But what is clear is that after a fantastic effort by the whole of the NHS and the volunteers who stepped up to help, there will be a backlog of patients who need help and care.
Unsurprisingly, one of the changes which will be included in the QOF requirements for this year include a new vaccination and immunisation domain, as included in the updated GP contract agreement. This will consist of four indicators which will replace the current Childhood Immunisation Directed Enhanced Service (DES).
The provision of vaccination and immunisation services will become an essential service for all routine NHS-funded vaccinations with two exceptions: childhood and adult seasonal influenza, which will continue as enhanced services, and COVID-19 vaccination. Full details of the immunisation and vaccination changes were detailed in a letter to GPs.
Mental health is something about which awareness and understanding is increasing. And rightly so.
This is represented in QOF, with the reintroduction of three indicators focused on patients with a serious mental illness. The aim is to promote improved uptake in the Serious Mental Illness Health Check.
It has been reported that the pandemic had a detrimental effect on those suffering from and with new symptoms of cancer – both from a supply and a demand perspective. Worryingly, some services have still not recovered to pre pandemic levels. These reductions in both the demand for investigation into symptoms and supply of treatments may, it has been calculated, contribute to substantial excess mortality amongst people with cancer and multiple morbidity. Those conducting the research concluded with the urgent need to understand the role in which general practice can help in mitigating excess mortality rates which have been estimated to be between 7000 and 17000 in just one year.
Consequently, cancer screenings and care have been included in the amendments to QOF for this year with a new indicator focused on cancer care and amendments made to the timeframe and requirements for the cancer care review indicator.
Of course, chronic disease reviews will still be at the centre of the QOF targets, the total number of points which have increased from 567 to 635 in 2021/22. The value of a QOF point will be £201.16 meaning £127,736.60 will be available for those practices meeting these target achievements.
For 2021/22, practices may deliver patient reviews remotely where clinically appropriate to do so, unless otherwise specified. For GP practices and Primary Care Networks who wish to capitalise on the funding opportunities such as the Covid Expansion Fund and Additional Roles Reimbursement Scheme, Medloop’s Patient Management Optimiser can help with remote reviews, risk stratifying patients and inputting SNOMED codes directly into the patient record.