Prior to writing this I had always assumed that FAQs were largely made up and consisted of things that the site owner wanted to say. Since this site has got more visitors when more people have asked questions about things that are not clear. Most of these questions have genuinely been asked.
Quality and Outcomes Framework (QOF)
- What is the QOF?
- In April 2004 following several years of negotiation most UK general practitioners moved to a new contract. One of the stated aims was to pay GPs for the quality of care given rather than just the size of their list (although things were never that simple). The Quality and Outcomes framework was the mechanism devised to enable this.
- How is the QOF structured?
- There were 1050 points up for grabs in 2005 and 2006. 130 of these are calculated from other points. Of the rest 550 are for clinical achievement and 420 for organisation. Each of these is further broken down into smaller areas. In the case of the clinical indicators there are eleven disease areas.
There were some changes in 2007 data onwards with only 1000 points but more points on the clinical indicators.
- How are the points calculated?
- For clinical areas there is an increase in points from a threshold achievement in each indicator until a ceiling value is reached. The threshold was 25% in 2005 and 2006 and rose to 40% from 2007. The ceiling differs between indicators.
For organisational indicators there is a Yes/No answer.
- Where can I find out more?
- The indicators are defined in detail in Annexe A of the GMS contract
The Data
- How is the data collected?
- For the most part the clinical data has been collected automatically from practices by software interrogating the practice computer. This is MSD Contract Manager in Wales and Northern Ireland and QMAS in Scotland and England.
- What happened to it then?
- The data was collected and used for payment of practices. It was published on spreadsheets separately for England, Scotland, Wales and Northern Ireland. Some data is suppressed where the numbers are low in order to preserve patient confidentiality. This data is the basis of this site as I extracted the data from the spreadsheets to feed into the database.
- When will it be updated?
- The data is uploaded to QMAS or contract manager on a monthly basis. Only the data at the end of March counts and so it is only this data that is published. Other data is difficult to interpret as practices will base their efforts around that date. Only at this time will all practices be on an equal footing.
The data is generally released around the end of September and I try to get it onto the site as quickly as possible after that.
Terms Used on the Site
- Area
- This refers to one of the indicators of the Quality and Outcomes Framework
- Numerator and Denominator
- For each area there is a number of patients in which that is achieved and a number of patients to which the area applies. These are the numerator and denominator.
Thus if you measured blood pressure in three patients and you needed to do four patients the numerator would be 3 and the denominator 4.
The exception to this is the disease registers themselves (mostly clinical indicators with the number one at the end). Just to make life easy I have made the numerator the register size and the denominator the practice list size. So 400 asthmatics in a practice of 8000 the numerator and denominatorwould be 400 and 8000 respectively.
- Ratio or Achievement
- This is simply the numerator divided by the denominator. This gives a percentage for achievement or, in the case of prevalence figures, a percentage prevalence.
- Centile
- This is simply a way of ranking each indicator. The top is 100 and the bottom is 0. In between the other numbers are distributed in rank order. There are actually two scales on the site as the figure for practices is calculated separately to that for PCTs
About the Site
- Who are you?
- My name is Gavin Jamie and I am a GP in Swindon. I am also studying for an MSc in Healthcare Informatics with the University of Bath. I run the site in my spare time. Hosting is remarkably cheap these days for a site of this size so I have not had to seek outside support directly. Yet.
- Why are you doing this?
- Mainly because I find this information interesting and usefull. Seeing how prevalences change across the country and possible factors involved in achievement is interesting. I am much less interesting in points, cash or league tables so these do not feature. Such is the luxury of having your own web site!
- Can I link to you?
- Please do. All the data for the pages is in the URL so you can link directly to your own practice or PCT. I will not change those links. I have no advertising to see so do not insist on visitors being sent to the 'front' page.
Updating details
- What does it mean to update my details?
- The address details that comes with the published QOF data is sometimes less than clear. It can also be out of date. By updating your details the correction will be used from then on. If your details change again I would ask you to change them here again.
The details are published in a format (hcard) (that makes it very easy for search engines and users to find your details.
- What about links to my website?
- You can enter a link to your practice website. This will appear on your page. This is possibly useful to users and again makes it easier for search engines to find your site. The link is again designed so that search engines can find your practice website more easily. It has happened not uncommonly so far that this site ranks above practice's own sites on Google which is not ideal.
- Why do I need a somthing@gp-X00000.nhs.uk type address?
- Somewhat to my surprise the NHS IT people have not yet provided a reliable way of making sure that a GPs identity on-line is who they say they are. This email address fudge is as close as I can make it. Many people who now have nhs.net address will have an old style address mapped accross.
