QoF results publication likely in next two months

Quality and Outcomes Framework results for every practice in England and Scotland are likely to be published on government websites within the next two months, according to the organisations responsible for coordinating the data.

An official from the Health and Social Care Information Centre in England, the body that will hold all Quality and Outcomes Framework data in England, wrote to a GP last week confirming that practice data would soon be publicly available.

In an email to Dr Gavin Jamie, a Wiltshire GP who is interested in collecting and analysing QoF data, Stuart Lynch, information governance consultant said that ‘detailed summaries’ of QoF information would be published.

He told Dr Jamie that The Information Centre will extract final Quality and Outcomes Framework (QOF) data for 2004/05 from the national QMAS system next month and hold it in a database called the Quality, Prevalence and Indicator Database (QPID).

He added: “Once the final year-end QOF data have been extracted from QMAS into the QPID database, we will work towards a rapid national release of summary data, and this is expected to be at practice level. The intention is to make this information generally available at no cost to users early in June 2005.”

Dr Jamie, who had been referred to the Information Centre after writing to most of the 300 plus PCTs in England, had asked for the release of the data held on QMAS under the Freedom of Information Act.

He asked for practice level data including a practice identifier, disease registers for all indicators where relevant and the numerator and denominator for each relevant area, for example the number of patients in each practice with diabetes and, from that figure, the number who have had their blood pressure measured in the last 15 months.

The email says: “The Information Centre is currently working to define the precise nature and format of the data to be published in June. The QPID database will not hold practice names, but will hold national codes to enable practices to be identified. We must also address any potential issues around the release of small numbers, where there is the potential to identify individual patients within practices by default. The information will be totally in the public domain and accessible via the Information Centre’s website .”

The email adds: “I anticipate that your requirements for QOF numerators and denominators, along with disease prevalence figures will be covered by the proposed data release.”

However the British Medical Association’s General Practitioner Committee says it is still in discussions about what QoF data will be published.

Dr Laurence Buckman, GPC deputy chairman, told EHI Primary Care that nothing had been decided yet. He said: "We would prefer that national averages were published and even PCT averages but our talks on this have been suspended because of the election so it’s totally speculative to say that anything has been decided."

In Scotland the organisation responsible for statistics, ISD Scotland, will be publishing QoF achievement levels on its website at the end of May. A spokesman for ISD told EHI Primary Care: “The QOF data for Scotland will be published as a National Statistics release on ISD’s website on 27 May. Total achievement points and payments at practice level will be included.”

A spokesperson for the DHSSPS in Northern Ireland said Quality and Outcomes Framework figures would be released on April 25, and no details of what kind of information that would include would be released until the day of publication.

Dr Graham Archard, vice chair of the Royal College of General Practitioners, said he had no doubt that practice level information will be published shortly.

He told EHI Primary Care: “Under the Freedom of Information Act people are entitled to know how practices have performed and I understand that there have already been so many enquiries from the public and the press that they have set up a special enquiry line to deal with it."

Dr Archard said that although he feels publication is inevitable he has concerns about interpretation of the results.

He added: “Although the Quality and Outcomes Framework gives an indication of quality it is by no means the only way of showing quality in practices. You have also got to compare like with like. For instance it’s a lot easier to do well on the framework in the leafy suburbs where I work than it is in an inner city area with a large turnover of patients and high deprivation. Without that information it would be a great concern if the public are looking at the results.”

One fear over the release of the information is that it will allow private companies to target practices for takeover by focusing on those who have failed to score highly under the framework.

After the Freedom of Information Act came into force at the beginning of the year private firms contacted PCTs to ask for release of interim QoF results. Government guidance issued at the time made it clear that PCTs had no choice but to release information asked for including quality framework audits, inspection reports and GPs’ aspiration and achievement levels.

Dr Jamie, who is doing an MSc in health informatics, believes the information presented on the Health and Social Care Information Centre website will be raw data which will be of little use to GPs or the public. However he hopes to process the information within a couple of days of the data appearing so that practices can visit a website he is setting up to compare their performance with others.

He says: “It’s not going to tell you a lot about individual practices and the feeling is that it will probably tell you more about the practice manager’s office than the consultation room but for the first time we will have accurate data for the whole country.

“There are an awful lot of questions you will be able to ask. For instance it’s suggested that prevalence might be higher in smaller practices and we’ll be able to see that in the data or you could look at if practices with good notes summarisation have different prevalence rates to those that don’t.”

Dr Jamie said that although practice codes would be used rather than names, the information that links the codes to practice names is available publicly, and therefore it would be relatively easy to identify each practice by name and address.