Practice by practice results for the Quality and Outcome Framework for England are being published today although technical problems have delayed the display of information.

The results show that the average score for practices in England last year was 958.7 out of a possible 1050. The maximum score of 1,050 points was achieved by 222 practices (2.6%).

In England the Health and Social Care Information Centre (HSCIC) is responsible for publishing the information and had intended to display the results from 9.30am today (August 31). However problems with the centre’s computer system meant the data was displayed at the sceduled time. A spokesman said the problems should be solved by 2pm and data will be available here.

A statistical bulletin published by the HSCIC shows that 8,486 practices in England took part in the QoF covering 99.5% of registered patients. Data on prevalence in 11 disease areas was collected for these practices and the highest recorded prevalence, 11.3%, was for hypertension.

Publication of the results showing each practice’s score for every indicator has been inevitable due to the requirements of the Freedom on Information Act but has led to concerns from the profession that results may be misinterpreted.

Dr Hamish Meldrum, chairman of the British Medical Association’s General Practitioner committee, said there was a danger of drawing unfounded conclusions from the information.

He said: “Firstly, the Quality and Outcomes Framework only covers certain aspects of a practice’s work. Also, this is a voluntary scheme and there may be many reasons why a practice has a lower score than its neighbours.

"A lower score does not necessarily mean that the practice is a lower quality one. For instance, a higher number of patients with certain types of disease could make the quality points more difficult to achieve, or a shortage of doctors or nurses in a practice with unfilled vacancies could have the same effect.

"Some practices may have decided to progress more slowly in the Framework and not attempted to take on all the points in the first year, although in reality they may be covering the work."

The statistical bulletin from the HSIC contains a section of advice on interpretation of the QoF data.

In bold type it states: “Measuring quality of care is not a simple process. The indicators on which this bulletin reports can only be proxies for true quality. Within the clinical domain the current QOF only covers conditions affecting a minority of patients and only some aspects of the care for such patients.

"However it does provide valuable information (on prevalence, cholesterol levels and blood pressure for example) on a scale previously unavailable, and will provide a baseline against which to measure future levels of improvement in the delivery of care.”

Dr Meldrum said the results also showed that for the first time GPs were able to demonstrate tangibly that they are providing a very high standard of care for their patients.

He said: “These are outstanding results and first and foremost they are good news for patients. The Quality and Outcomes Framework in the new national GP contract has shown that GPs can quickly adapt to new and better ways of working. These results are mirrored throughout the UK and are proof that investment in general practice pays off.”

Practice by practice results for Northern Ireland and Wales were also due to appear today but publication has been delayed. Northern Ireland results will now appear on on 8 September and Wales results are due to appear on 16 September. A spokesperson for the Welsh Assembly said data was still being verified with local health boards . Scotland published its results on 27 May.

GP software supplier, EMIS, says practices using its system are doing better than others under the new rewards system. Preliminary figures compiled by the company priot to publication of the full data this week indicate that practices in England using EMIS gained an average of 984.6 points last year, compared to an average of 952.8 points gathered across the other clinical systems.

 In Scotland, the company says EMIS surgeries are scoring an average of 1,004 points per year, compared with the Scottish average of 971.3. Four out of 53 practices achieved 1,050 points – the maximum possible – during 2004/5 using the system.

The company says the high scores are all down to the way EMIS’s Population Manager is an integrated part of the main clinical system: “Practices need only enter data into any area of the system once, and it is automatically populated into the contract searches.”


QoF results in England