This support article attempts to explain the calculations behind your QOF income. It is something which will perplex primary care forever, but see below our understanding.
As you know, a QOF point value varies according to practice size and uses 3 figures in its calculation:
- Basic value per QOF point (£194.83 for 2020/21)
- Contractor population index (CPI) which is practice list size divided by national average list size – (8799 in 2020/21)
- Adjusted Practice Disease Factor (ADPF) –– adjusts payment according to whether practice prevalence is below or above national average by following formula for each disease area:
Thus a QOF point for each domain is worth £194.83 x CPI x ADPF
Which means that the average practice, with average list size (8799) and average prevalence for a QOF area, would receive £194.83 per point.
So, looking at the effect this has on domains:
Dementia – a practice has 53 patients on the register currently:
|Practice list size || 10000|
|Dementia – current register ||53|
|Practice prevalence||0.53% (53/10000)|
|National Prevalence||0.78% (available on www.gpcontract.co.uk)|
|QOF point value||£150.91 (£194.83 x 1.14 x (0.53/0.78)|
|Max Domain value (44 points)||£6,640.41|
But, if the register were increased to 70:
|Practice list size ||10000|
|Dementia – current register ||70|
|QOF point value||£198.71 (£194.83 x 1.14 x (0.7/0.78)|
|Max Domain value (44 points)||£8743.37|
Or, to look at it in a different way, each Dementia patient is worth around £125.
Thus prevalence is very important. In fact, increasing your prevalence can be worthwhile even if it means a corresponding reduction in achievement of QOF points.