QOF Guides – How we estimate disease prevalence

Most practices get close to the maximum number of points each year so the biggest influence on practice income from QOF is disease prevalence. The potential cash value is worked out nationally after the end of the year by dividing a fixed pool of money for each disease area between practices according to their register size.

The exact prevalence figure is not known until after the end of the QOF year, but we can estimate it based on the latest available QOF data and taking into account trends in prevalence from year to year – for example, based on current trends, diabetes tends to rise a little, while coronary heart disease falls.

Using this estimate of the prevalence we can then divide the total payment potentially available by our estimate of the number of patients on each register to work out the payment per patient.

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