27.3.20 URGENT – QOF year end 19/20 payment update
NHS England and Improvement published a letter on Thursday 19 March 2020 which confirmed that calculations for QOF 2019/20 will be made as usual. This data submission will be followed by a piece of analysis to understand the impact of Covid-19 and a one-off financial adjustment for practices who earned less in 2019/20 than 2018/19 as a result of Covid-19 activities.
This letter also committed that NHS England and Improvement will ensure that funding does not influence clinical decision making by ensuring that all GP practices in 2020/21 continue to be paid at the same rates. This assumes that they would have continued to perform at the same levels from the beginning of the outbreak as they had done previously, including for the purposes of QOF, DES and LES payments. However, to do this we will still need to collect year end data and to enrol practices into QOF for 2020/21. Currently, we also plan to collect QOF achievement data at the end of 2020/21 prior to any income protection being applied.
To ensure that QOF payments are processed as smoothly as possible during this period, changes are necessary to usual user functions and processes as staffing shortages and operational pressures mean that not all practices and commissioners will complete data entry, validation and participation activities within the required timeframes.
There are three changes which will be made to the CQRS system at the request of NHS England and Improvement to ensure that GP Practices get paid for QOF year end 2019/20 payments and are able to participate in the 20/21 QOF service and receive aspiration payments. These changes are:
- Participation in QOF FY2020/21
CQRS will offer and automatically accept this service to any GP Practice which have not yet participated but who have participated in FY2019/20. If a GP Practice subsequently does not want to participate you should contact your local commissioner who will be able to retract the offer.
- Manual Indicators for QOF FY2019/20
CQRS will automatically populate the four manual indicators to “yes” for any GP Practice who is yet to submit their manual indicators. A GP Practice will be able to amend this in the system up to 11pm on Tuesday 31 March. Any GP Practice who is paid significantly more or less as a result of these manual indicators (taking into consideration factors such as list sizes and mergers) will be highlighted to their commissioner who we would expect to investigate and adjust the payment where necessary. This amended payment will be an off-system adjustment.
- Auto-Declaration and Financial Approval of payments
All achievement payments for QOF 19/20 will be automatically declared and approved within the CQRS system. GP Practices will not be required to declare any achievement payments. Aspiration payments will be automatically financially approved as usual.
During the year end calculation, NHS England and Improvement with NHS Digital will interrogate the calculated data and ensure that no GP Practice is paid less than the previous financial year. Commissioners will be alerted to any practices who are significant outliers so that data can be checked and amended where necessary. This amended payment will be an off-system adjustment.
Commissioners can use the post achievement modelling tool in CQRS to calculate an adjusted payment should this be required. Page 80 of this document provides further information