QOF Payments in each PCT
The treatment targets set for patients during the first 6 months of the study are less stringent than those demanded by the quality and outcomes framework (QOF). This is essential to allow the lifestyle intervention to have an effect before seeking to intervene pharmacologically. We realise that under these conditions, practice participation in the Early ACTID study may negatively impact on the practices QOF return. To ensure this does not happen, we have obtained agreement from the Director of Primary Care in each PCT that is involved with Early ACTID. The agreements range from simple exclusion (Option 1) to full award of QOF points for patients that participate in the study (Option 3). The table below shows which option each PCT has agreed to, below that is the definition of each option as described to the PCTs.
|
PCT |
Contact |
Option |
|
Cheltenham & Tewkesbury |
Paul Edwards |
1 |
|
Cotswold & Vale |
Denise Lawrence |
2 |
|
Mendip |
Alison Barkshire |
2 |
|
North Somerset |
Tony Adams |
2 |
|
Somerset Coast |
David Slack |
2 |
|
Taunton Deane |
Jenny Fletcher |
2 |
|
Bath & NE Somerset |
Yvonne Planchant |
2 |
|
Bristol North |
Jill Sheppard |
2 |
|
South Gloucestershire |
Lynda Dando |
3 |
|
South Somerset |
Mal Lee |
2 |
|
West Gloucestershire |
Claire Hathaway |
1 |
|
Bristol S&W |
Trevor Beswick |
2 |
Description of options:
Option 1: In the same way that violent or uncooperative patients can be excluded from QOF returns, these individuals are excluded as well. This ensures that researching different treatment modalities will not jeopardise QOF returns and payments. This requires PCTs to accept a small increase in excluded individuals in research active practices.
Option 2: In the same way that violent or uncooperative patients can be excluded from QOF returns, these individuals are excluded from categories of the QOF return for certain defined parameters which are likely to be affected by a study (In this case I refer specifically to DM 6, 7 and 12).
DM6 - %age of patients in whom last HbA1C is <=7.4
DM7 - %age of patients in whom last HbA1C is <10
DM12 - %age of patients in whom last BP is <=145/85
By providing all other data gathered on a patient to their GP, these data could go to make up the total numbers in the practice and count toward the QOF return. In respect of blood pressure and HbA1C the GP is therefore only assessed in terms of the individuals directly under their care and having their patients in Early ACTID would not jeopardise QOF returns under DM6, 7 and 12.
Option 3: All individuals recruited into Early ACTID are assumed to have reached their targets. The data required for the diabetes part of the QOF return are collected during the research study, will be provided to GPs and are therefore available for evaluation.