Last review date 03/02/2023


Increase your QOF income

Ardens includes reports on SystmOne to help increase your QOF income. Practices who use this frequently can increase their income by £3,000 a year and more. All of this can also be monitored and reviewed on Ardens Manager.


The QOF Case Finder clinical reports identify patients who may have not had a diagnosis coded correctly for QOF. This means that they never enter on to your QOF register (eg asthma, diabetes, etc), resulting in lost income. By increasing the prevalence of a disease at your surgery, you increase the amount of money per QOF point that you receive. This therefore results in a greater QOF income for your practice for this year and every year after (that QOF exists for!)


Examples of reports

  • On Insulin but no Diabetes
  • Home BP >135/85 but no Hypertension
  • H/O Atrial Fibrillation but no Atrial fibrillation
  • Coronary artery graft but no Coronary artery disease
  • On diuretic & BNP >100 but no Heart failure


Instructions

1. Go to Clinical Reporting > Ardens Ltd > Contracts | 2024 25 | QOF > Case Finders & run the reports
2. Right-click a report > Show Patients and open a patient's record

3. Go to the journal, clear all the filters & search their record then either:


4a. Record The Diagnosis 

If the patient has been identified correctly, go to Auto-consultations > Ardens Contracts and use the Ardens QOF template to add the appropriate code. Remember also to back date the read code to the date of actual diagnosis.


4b. Exclude The Diagnosis

If the patient has been identified but does not have the condition you can potentially exclude them from the report by using the ‘Diagnosis Excluded’ template . This template can be found under Auto-consultations > Ardens General. Please not that adding one of these codes will not always exclude patients from certain reports, usually for clinical safety. 


Examples of reports to add the 'diagnosis excluded' codes to include where the patient is on medication or has had an operation that is associated with a condition, but they do not actually have that condition. e.g. ?Mental Health as on lithium


4c. Mark The Code In Error

If the patient has been identified due to an incorrect code on their record, you can remove them from the report by marking this code in error.


Examples of codes to mark in error include 'h/o COPD' or 'COPD monitoring' when the patient does not actually have COPD.



Please note:

> Add the specific QOF template and 'Diagnosis Excluded' template to your F12 Favourites for quick access. 

> For the ‘?Cancer as Histology’ report, right click > breakdown > breakdown by read code > then view record



Tips

  • Set-up the Ardens QOF Alerts correctly. See Set-up for further details.
  • Going through some of these reports is quick whilst others take a bit more time, but they’ll all increase your income 
  • To check a patients record, go to Tabbed Journal, remove any filters and type in search box
  • Use the SystmOne QOF tools too. Go to Reporting > QOF Indicators




National Prevalence Day & Further QOF Work To-Do

'National Prevalence Day' is the date when your practice prevalence data is taken which determines your practice QOF income. The date used to be 14th February but is now 31st March. 


This means that you have until the 31st March to increase your QOF registers by using our QOF Health Check reports in order to increase your QOF income for that financial year.


It is a common concern from practices that if they increase their prevalence of a QOF disease register, their practice QOF income will fall as there will be outstanding QOF work to do that has not been completed yet. From our experience though, most of the QOF work for miscoded patients has already been done. These patients are usually coming in routinely for their annual reviews already, it is just that the clinician has not noticed they are not on QOF registers.

The exception to this is osteoporosis where patients may need a DEXA scan or heart failure patients who may need an echocardiogram. These patients are worth about £117 and £81 each respectively, so we think it is worth doing this piece of work, not only for the financial implications but for best practice too.

If it is January or February and you are pushed for time at the end of the financial year, we suggest practices focus on the high value areas now as these patients will be worth recalling if needed and to leave the other areas until after April.


Disclaimer

These reports identify potential coding errors where a patient does not have the correct read code to place them on the QOF register. Each patient should have their record reviewed and clinical judgement should be used to decide whether or not the patient should be added on to the QOF disease register. The total patient count and missed income may be less as one patient may appear on two reports, for example on the ?Dementia as on repeat meds and ?Dementia as h/o dementia report If a patient is added to a QOF register, there may be further outstanding QOF work that is required in order to achieve the full amount of missed income available. For reports like ?Osteoporosis and ?Heart failure, investigations like DEXA scans and echos may be required to confirm the diagnosis before you add the patient to your QOF registers. The 'Time To Do' calculations are based on it taking on average 3 minutes per patient to review their record and add a QOF disease register code if appropriate. If a 'Time To Do' states 1 day, this is 24 hours of work, so in practice would take 3 days working for 8 hours a day. These reports are only intended for use as a guide and Ardens does not guarantee or take responsibility for any of the data that is produced from these reports.