QOF business rules coding issues – update for practice teams

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Please note that no action is currently needed by practices on this matter, but you should read the information carefully.

Following the introduction of the SNOMED-CT coding in 2018/19, NHS Digital’s business rules team has been converting and mapping the READ and CTV3 codes into SNOMED, which has proved difficult and complex.

Although there was always an expectation that there would be some errors as there are each year with the baseline version of QOF, a larger number than in previous years have been detected:

  • 85 codes have been identified and queried from the v39 baseline QOF business rules (0.5% of all the codes).
  • Of these 85 queried codes, 67 were incorrect and have been changed in v41 of the business rules.
  • The 67 codes that have been changed impact on the following QOF registers:
    • AF
    • CHD
    • Asthma
    • CVD
    • Dementia
    • Epilepsy
    • Heart failure
    • Osteoporosis
    • Smoking
    • Stroke

It was therefore agreed that v40, the mid-year release, would not be implemented as new errors were continuing to be reported, and that v41 would be used instead.

QOF data on the EMIS system or in CQRS may currently seem inaccurate, but this will be addressed by v41, which is the version which will be used for payment.

NHS England and NHS Digital are aware that as a result of this, there may be closer scrutiny to achievement at year end than usual and additional work for practices and commissioners.

As a result, there may also be an increase in queries raised before practices and commissioners are happy to sign off achievement. NHS England will contact local commissioners and NHS England local teams requesting that where possible they support practices in resolving any queries as quickly and efficiently as possible and ensuring workload is kept to a minimum. NHS Digital will ensure their customer service team are fully briefed on the issues raised and will anticipate the possibility of an increase in activity this year end. The support teams will be ready and able to support practices with their queries.

Thanks to Surrey and Sussex LMCs for sharing this information.

Last updated : 06 Feb 2019