Quality and outcomes framework guidance:

Summary of indicators - organisational domain
2011/12

Records and Information
Records 3 - 1 point
The practice has a system for transferring and acting on information about patients seen by other doctors out of hours

Records 8 - 1 point
There is a designated place for the recording of drug allergies and adverse reactions in the notes and these are clearly recorded

Records 9 - 4 points
For repeat medicines, an indication for the drug can be identified in the records (for drugs added to the repeat prescription with effect from 1 April 2004). Minimum Standard 80%

Records 11 - 10 points
The blood pressure of patients aged 45 and over is recorded in the preceding 5 years for at least 65% of patients

Records 13 - 2 points
There is a system to alert the out-of-hours service or duty doctor to patients dying at home

Records 15 - 25 points
The practice has up-to-date clinical summaries in at least 60% of patient records

Records 17 - 5 points
The blood pressure of patients aged 45 and over is recorded in the preceding 5 years for at least 80% of patients

Records 18 - 8 points
The practice has up-to-date clinical summaries in at least 80% of patient records

Records 19 - 7 points
80% of newly registered patients have had their notes summarised within 8 weeks of receipt by the practice

Records 20 - 12 points
The practice has up-to-date clinical summaries in at least 70% of patient records

Records 22 - 11 points
The percentage of patients aged over 15 years whose notes record smoking status in the past 27 months, target 90%

Information 5 - 2 points
The practice supports smokers in stopping smoking by a strategy which includes providing literature and offering appropriate therapy

Education and Training
Education 1 - 4 points
There is a record of all practice-employed clinical staff having attended training/updating in basic life support skills in the preceding 18 months

Education 5 - 3 points
There is a record of all practice-employed staff having attended training/updating in basic life support skills in the preceding 36 months

Education 6 - 3 points
The practice conducts an annual review of patient complaints and suggestions to ascertain general learning points which are shared with the team

Education 7 - 4 points
The practice has undertaken a minimum of twelve significant event reviews in the past 3 years which could include:

A significant event occurring when a patient may have been subjected to harm, had the circumstance/ outcome been different

Education 8 - 5 points
All practice-employed nurses have personal learning plans which have been reviewed at annual appraisal

Education 9 - 3 points
All practice-employed non-clinical team members have an annual appraisal

Education 10 - 6 points
The practice has undertaken a minimum of three significant event reviews within the last year

Practice Management
Management 1 - 1 point
Individual healthcare professionals have access to information on local procedures relating to Child Protection

Management 2 - 1 point
There are clearly defined arrangements for backing up computer data, back-up verification, safe storage of back-up tapes and authorisation for loading programmes where a computer is used

Management 3 - 0.5 points
The Hepatitis B status of all doctors and relevant practice-employed staff is recorded and immunisation recommended if required in accordance with national guidance

Management 5 - 3 points
The practice offers a range of appointment times to patients, which as a minimum should include morning and afternoon appointments five mornings and four afternoons per week, except where agreed with the PCO

Management 7 - 3 points
The practice has systems in place to ensure regular and appropriate inspection, calibration, maintenance and replacement of equipment including:

Management 9 - 3 points
The practice has a protocol for the identification of carers and a mechanism for the referral of carers for social services assessment

Management 10 - 2 points
There is a written procedures manual that includes staff employment policies including equal opportunities, bullying and harassment and sickness absence (including illegal drugs, alcohol and stress), to which staff have access

Medicines Management
Medicines 2 - 2 points
The practice possesses the equipment and in-date emergency drugs to treat anaphylaxis

Medicines 3 - 2 points
There is a system for checking the expiry dates of emergency drugs on at least an annual basis

Medicines 4 - 3 points
The number of hours from requesting a prescription to availability for collection by the patient is 72 hours or less (excluding weekends and bank/local holidays)

Medicines 6 - 4 points
The practice meets the PCO prescribing adviser at least annually and agrees up to three actions related to prescribing

Medicines 8 - 6 points
The number of hours from requesting a prescription to availability for collection by the patient is 48 hours or less (excluding weekends and bank/local holidays)

Medicines 10 - 4 points
The practice meets the PCO prescribing adviser at least annually, has agreed up to three actions related to prescribing and subsequently provided evidence of change

Medicines 11 - 7 points
A medication review is recorded in the notes in the preceding 15 months for all patients being prescribed four or more repeat medicines. Standard 80%

Medicines 12- 8 points
A medication review is recorded in the notes in the preceding 15 months for all patients being prescribed repeat medicines. Standard 80%

Quality and productivity

QP1 - 6 points
The practice conducts an internal review of their prescribing to assess whether it is clinically appropriate and cost effective, agrees with the PCO three areas for improvement and produces a draft plan for each area no later than 30 June 2011

QP2 - 7 points
The practice participates in an external peer review of prescribing with a group of practices and agrees plans for three prescribing areas for improvement firstly with the group and then with the PCO no later than 30 September 2011

QP3 - 5 points
The percentage of prescriptions complying with the agreed plan for the first improvement area as a percentage of all prescriptions in that improvement area during the period 1 January 2012 to 31 March 2012 (Payment stages to be determined locally according to the method set out in the indicator guidance below with 20 percentage points between upper and lower thresholds)

QP4 - 5 points
The percentage of prescriptions complying with the agreed plan for the second improvement area as a percentage of all prescriptions in that improvement area during the period 1 January 2012 to 31 March 2012 (Payment stages to be determined locally according to the method set out in the indicator guidance below with 20 percentage points between upper and lower thresholds)

QP5 - 5 points
The percentage of prescriptions complying with the agreed plan for the third improvement area as a percentage of all prescriptions in that improvement area during the period 1 January 2012 to 31 March 2012 (Payment stages to be determined locally according to the method set out in the indicator guidance below with 20 percentage points between upper and lower thresholds)

QP6 - 5 points
The practice meets internally to review the data on secondary care outpatient referrals provided by the PCO

QP7 - 5 points
The practice participates in an external peer review with a group of practices to compare its secondary care outpatient referral data either with practices in the group of practices or with practices in the PCO area and proposes areas for commissioning or service design improvements to the PCO

QP8 - 11 points
The practice engages with the development of and follows three agreed care pathways for improving the management of patients in the primary care setting (unless in individual cases they justify clinical reasons for not doing this) to avoid inappropriate outpatient referrals and produces a report of the action taken to the PCO no later than 31 March 2012

QP9 - 5 points
The practice meets internally to review the data on emergency admissions provided by the PCO

QP10 - 15 points
The practice participates in an external peer review with a group of practices to compare its data on emergency admissions either with practices in the group of practices or practices in the PCO area and proposes areas for commissioning or service design improvements to the PCO

QP11 - 27.5 points
The practice engages with the development of and follows three agreed care pathways (unless in individual cases they justify clinical reasons for not doing this) in the management and treatment of patients in aiming to avoid emergency admissions and produces a report of the action taken to the PCO no later than 31 March 2012