QOF changes for 2021/22 explained

NHS England and the BMA have indicated that QOF will resume in full from April, with minimal changes to indicators. Updates include that the four flu indicators are to be retired while exception reporting will not apply to the new childhood immunisation indicators. Read our summary below and the full guidance is available here.

In a joint letter to practices outlining the changes for 2021/22, NHS England and the BMA GP Committee explained that QOF 2021/22 would be based on the indicator set already agreed, with very limited changes, ‘to provide practice stability and support recovery’.

The letter added: ‘The reinstating of QOF in full will support the recovery of long-term condition management.’

Key updates

The size of QOF has increased from 567 to 635 points in 2021/22, while the value of a QOF point in 2021/22 will be £201.16 and the national average practice population figure will be 9,085.

There are no changes to payment thresholds for those indicators that are carried forward from 2020/21.  

The letter states that practices can deliver patient reviews remotely where clinically appropriate, unless otherwise specified. Face-to-face reviews are recommended for patients with dementia.  

Among newly announced details are that the four flu indicators in different clinical areas are being retired.

In addition, exception reporting – now termed personalised care adjustment – will only apply to the new QOF indicators for childhood immunisations where vaccination is contraindicated, rather than for example, if vaccination is declined.

By contrast, for the new shingles QOF indicator, practices may use a personalised care adjustment if the vaccine is contraindicated or if the patient has declined vaccination.

In summary, key changes for 2021/22 include:

• A new vaccination and immunisation domain (as previously agreed in updates to the five-year GP contract agreement) consisting of four indicators to replace the current Childhood Immunisation Directed Enhanced Service (DES). Three of these indicators focus on routine childhood vaccinations and one on incentivising the delivery of shingles vaccinations.

• The reintroduction of three indicators focused on patients with a serious mental illness to promote improved uptake in all six elements of the SMI physical health check.

• A new indicator focused on cancer care has been introduced and amendments made to the timeframe and requirements for the cancer care review indicator.

• The four flu indicators have been retired with incentives relating to flu vaccination for target groups being introduced in the Investment and Impact Fund.

• The date of diagnosis has been amended to ‘on or after April 2021’ for the asthma, heart failure and COPD diagnostic indicators.

• As previously announced in updates to the GP Contract for 2021/22, the Learning Disabilities and Supporting Early Cancer Diagnosis Quality Improvement modules are to be repeated in their intended format (prior to amendments for the refocusing of QOF in September 2020) with some slight modifications to account for the impact of the pandemic on care.

Full details of the revisions to QOF can be seen in the revised guidance for 2021/22 here.