This folder supports practices in delivering and monitoring annual QOF care for patients with a diagnosis of severe mental illness. The relevant indicators cover care planning, alcohol and physical health monitoring, and include exception opportunities (PCAs) when care cannot be delivered.
Patients with one or more unmet mental health indicators (e.g. care plan, alcohol, BMI, BP, glucose/HbA1c, or lipids) who have received one invitation.
Action: Send a second invitation to allow exception coding for any indicators still outstanding.
Same as above, but patients have now received two invitations.
Action: These patients are now eligible for exception reporting for any indicators not completed.
Patients who did not have a coded care plan in the previous QOF year. Indicates disengagement or missed care – ideal for recall or exception coding review.
Patients who are missing 1 of the QOF mental health indicators this year. Quick to resolve – often a single check or coding issue.
Patients missing 2 of the 6 mental health indicator components.
Tip: Resolving even one can improve QOF payment banding.
Patients missing 3 or more indicators. These are high-priority for follow-up or review for potential PCAs if care cannot be completed.
Patients with no care plan coded this year and a past PCA recorded.
Action: Review whether the same reasoning still applies.
Patients with no blood pressure reading and previous PCA. Check for reapplication or assess if a BP can now be taken.
Patients with BMI check outstanding and previous exception applied. Consider reapplying PCA if remains unsuitable.
Patients with no HbA1c or glucose check, and a prior PCA applied.
Action: Consider whether bloods are now possible or a new PCA is needed.