The RAFT programme will help practices’ achievement on these new QOF Quality Improvement indicators (QI016, QI017, QI018 and QI019).
The GP contract for 2023/24 introduced new Quality Improvement domains, one of which focuses on ‘optimising demand and capacity’. This is already a major focus of the RAFT programme, and practices who participate in RAFT are expected to find it easy to achieve the QOF points for these indicators without having to undertake additional work.
Requirements in QOF
This is a summary of the information from NHS England about the QOF requirements (p100 onwards).
Part 1: Optimise use of staff capacity
- Indicator QI016. 10 points. The contractor can demonstrate that it has in place a recognised and validated approach to understanding demand/activity, capacity and appointment data and has made improvements to data quality to better reflect practice work.
- Indicator QI017. 6 points. The contractor can demonstrate that it has utilised demand and capacity data to inform operational decisions and plan for demand and capacity matching.
- Indicator. QI018. 6 points. The contractor has participated in network activity to review the smart cards of all staff employed under the Additional Roles Reimbursement Scheme (ARRS). [The RAFT programme will not address this indicator]
Part 2: Reducing avoidable appointments
- Indicator QI019. 15 points. The contractor can demonstrate improvement in reducing avoidable appointments.
The focus of the indicators and associated points is on contractor engagement and participation in the quality improvement activity both in the practice and through sharing of learning across their network. This is to recognise that not all quality improvement activity will be successful in terms of its immediate impact upon patient care. If a contractor does not achieve the targets which they have set themselves this would not in itself be a reason to withhold QOF points and associated payments, unless they have also failed to participate in the activities described in the guidance.
Practices are free to develop their own improvement plans to address the priorities they identify. The QOF guidance provides some suggestions, but is careful to note these are suggestions only. It IS expected that practices will discuss their situation, opportunities and plans within the PCN, and that at least some of the improvement ideas will be based around PCN collaboration. It is suggested that the PCN discussions take note of opportunities in the wider locality and that they can be facilitated externally.
The ICB will require evidence (eg self-declaration) of the activities the practice has engaged in, the plans developed and the progress made so far. The key elements of the nationally provided reporting template are:
- What area of demand and capacity did the practice identify for quality improvement?
- What was the defined “Smart Aim” of your quality improvement work?
- What were the changes you tested?
- What changes have been adopted?
- How will these changes be sustained in the future?
- What measures/indicators did you use to track your improvement?
- Did you observe improvements in relation to these measures/indicators? Please provide details of any improvements achieved.
- How did the network peer support meetings and patient participation influence the practice’s QI plans on optimising access?
How will RAFT help?
BSol practices who participate in the RAFT programme are expected to achieve full points for QOF indicators QI016, QI017 and QI019. There will be a minimal administrative burden, as the planning and reporting templates will be included in the project management templates used in the locality collaborative programme.
- Understand patterns of demand. One of the early RAFT forums will support practices to review and discuss their data about demand and capacity. We will particularly focus on what the data says about how clinician rotas and the appointment book can be better matched to demand.
- Measure avoidable appointment rate. Practices will be able to access a free rapid audit which measures the proportion of GP appointments that were potentially avoidable. The data will be discussed in the RAFT forums.
- Develop business intelligence. The PSU will work with practices through the RAFT programme, to understand their business intelligence (BI) needs and agree how to develop tools and skills.
- Discuss and plan. The RAFT forums are geared towards providing each PCN with plenty of time to take stock of the current situation, share ideas, learn together and develop action plans. Standard templates will be provided for planning.
- Improve and measure. Practices will implement the changes they chose to prioritise. They will be able to use the free appointments audit to measure the impact. This is such a quick audit that practices may wish to measure a snapshot every month or two.
- Report for QOF. The survey and templates used will provide each practice with a ready-made report for QOF reporting and CQC evidence.