News

Exception reporting used to boost practice profits

09-Aug-07

Practices performing poorly in the quality and outcomes framework (QOF) are using exception reporting to boost their profits, according to a study from the Centre for Health Economics

Using QOF data from practices in Scotland researchers found that those who performed worse in 2004/5 QOF results were more likely to have high exception reporting in 2005/6.

They estimated that more than 10 per cent of patients were inappropriately reported as exceptions.

'Exception reporting removes incentives towards inappropriate or overtreatment of patients. But the QOF provides perverse incentives for gaming of exceptions,' the study concluded.

The study also found that practices which performed worse in 2004/5 had lower reported prevalence in 2005/6. There was also an association between reported prevalence rates and practice characteristics, such as if a practice had been a fundholder in the past.

The researchers said that these results suggested that QOF prevalence reports may not be a reliable epidemiological resource.

Comment below and tell us what you think

Comments

3 comments

Mairi Dickson

09/08/2007

Your report seems to indicate that practices have been cheating their way into better figures this year. However the article does not take into account that in the first two years of the contract many practices did not exception report because the rules for doing so were somewhat vague and they were afraid to exception report wrongly. Indeed the increase in reporting may in many cases be due to practices being more aware of the fact that after chasing up patients many times to attend for clinics (usually more often than the required minimum of three times) we then felt entitled to exception these patients. This means that the figures were actually unnaturally low in first couple of years rather than unfairly high last year. I do however agree that this leads to prevalence figures being somewhat skewed.

Mohammed Ahmed

10/08/2007

There is exception to everything. Majority of us do work hard but few (in this case may be a few more) ROTTEN apples give bad name. It is wrong to use exception reporting if you contact the patient 3 times in Feb and March of the year and then use the exception reporting. I am aware of GP's who told me that they sit down in Jan to March to achive QoF points. For some it is just ticking the boxes, for others it is patient care. The other read code used is maximum therapy inappropriately.

Colin Cooper

10/08/2007

The conclusion that 'the QOF provides perverse incentives for gaming of exceptions' was not borne out in the data from the NHS Information Centre for England in 2005/6, which showed a low overall exception rate of 5.6 per cent. NHS Employers commented at the time: 'There is no evidence of large-scale overuse of exception reporting.

Only registered users may comment. Log in now or register for a free account.