- Posted Monday February 29, 2016
Practices everywhere can breathe a sigh of relief on the 31st March, because the QOF rush is over for another year.
The 31st of March is a bit like New Year's Eve in general practice. It’s a time to celebrate and reflect; time to stop waking up in a pool of QOF-induced sweat during the night. The 1st of April is a bit like New Year's Day, time to promise yourself it’s all going to be different this year. Full of promises that patients will not be locked in the waiting room until they have all received smoking cessation advice.
"This year will be different," we’ll say. So what can practices do to make sure their resolutions aren’t going to fail?
As a relatively newish practice manager I walked in on the 31st January 2011 to a sea of glum faces dreading the upcoming months of February and March. Hundreds of phone-calls and letters were made in chaotic scenes as patients came in throwing their demanded urine bottles at staff. Very briefly I wanted my old job back.
Over time I realized that it didn’t really have to be that way, so here are some tips I’ve built up over time that have worked for me.
1. Get the whole team involved
This is the most important tip. I was amazed that some of the clinical team didn’t know what QOF actually meant. Pop ups were seen, but nobody really realised how many biscuits that income could buy.
To help with this, hold quarterly QOF meetings with all the staff. Your receptionists have more contact with patients than anybody, so explain what QOF is, show them the targets and what it means financially. Show them where the reports are in the clinical system.
When everyone is involved, it becomes a whole attitude to getting the work completed and not just yours.
2. Spend half an hour a day doing the work
This one takes some time but it’s worth it.
How often on the clinical system do you see the QOF pop up box closed down by doctors and nurses? It gets in the way, apparently.
Go through the appointments that day (or get someone else to do this) and write underneath every appointment whether there is QOF work to be done or not. It sounds time consuming, but so is getting 400 asthmatics through the door in March. By getting someone to spend half an hour a day on it, so much more work will be done opportunistically and nobody can say ‘I didn’t know!’
3. Work opportunistically
Talking of opportunistic working, this is the key to QOF work being done as the 12 months go by. Is there anything more frustrating than someone who needs smoking cessation advice and they have been in ten times that year?
Send reminders to staff to keep a look out for the pop ups and to do the work opportunistically. If they can’t do the work there and then, get the patient booked for their asthma check at the time they’re seen.
4. Target flu season
Use the opportunity when thousands of patients will be knocking on your door to get some QOF work done too - a simple tick box works well.
When your health care worker or nurse is administering the flu jab, a quick look at the QOF pop ups will tell you whether anything else needs doing. Simply create a sheet with a tick box (eg asthma review, diabetic review, blood tests etc), tick what applies and give it to the patient, who can then take it to reception and book their appointment or get their blood form. Done.
5. Use your clinical system effectively
There are many really useful tools in clinical systems that can transform documentation. A protocol for can mean that recording a flu vaccination could take 10 seconds. Again, the simplicity of it encourages clinicians to undertake opportunistic working.
6. Have a member of staff ready to recall patients
Print out the reports monthly and ensure you have a member of staff who is available to recall patients. Don’t waste money on letters unless you get no response. Ringing patients is usually much cheaper and a quicker and more effective way of getting appointments booked in.
7. Use tools that you already have to remind patients to come in
Prescriptions can be used for messages, telephone answering machines, emails – all can include a reminder. Also ensure your website is up to date. You can help patients keep in touch by having a newsletter where they can subscribe too. Patients enjoy being involved.
These are my tips, but if you've got your own why not share them? This year we can stick to our new year resolutions and hopefully avoid the hangover.
FPM Members can make QOF easier with our QOF Aspiration And Achievement Monitoring Toolkit and our Quality And Outcomes Framework Index.