Will QOF Changes Impact My Practice’s Financial Stability?

Will QOF Changes Impact My Practice’s Financial Stability?

Overview

Notes
The 2025/26 QOF contract brings significant changes to indicators, thresholds, and funding allocations. Practices that do not adjust their approach may see financial losses, while those who optimise workflows stand to increase income.

Key Financial Changes in QOF 2025/26

  1. Retirement of income-protected indicators, requiring practices to replace lost income elsewhere.
  2. Higher thresholds for certain indicators, making full achievement harder.
  3. Reallocation of funding towards CVD prevention and chronic disease management.
  4. More focus on proactive care, with practices rewarded for early intervention.

Action Points:

  1. Identify which retired indicators impact your practice's income.
  2. Adjust clinical priorities to align with high-value QOF indicators.
  3. Implement performance tracking to meet new thresholds.

What Are the Financial Risks?

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1. Loss of Income from Retired Indicators

Risk: Several indicators have been removed, and income protection has ended. If practices do not shift focus to new indicators, overall QOF earnings may decrease.

Key Takeaways:

  1. Review Annex B of the contract to see which indicators have been retired.
  2. Prioritise new QOF indicators that offer high financial value.
  3. Ensure staff are aware of coding and documentation requirements for new measures.

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2. Increased Performance Thresholds

Risk: Higher achievement thresholds mean practices must improve patient outcomes to secure full QOF payments. If thresholds are not met, practices could see a drop in earnings.

Key Takeaways:

  1. Regularly track QOF performance and identify underperforming areas.
  2. Ensure accurate coding so all eligible patients are counted.
  3. Use automated recall systems to engage patients before deadlines.

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3. Funding Shift Towards Prevention & Long-Term Condition Management

Risk: More funding is being directed towards CVD prevention and chronic disease management. Practices that fail to proactively manage these patients may lose out on income.

Key Takeaways:

  1. Focus on CVD prevention, lipid management, and blood pressure control.
  2. Ensure early intervention strategies are in place to meet targets.
  3. Train staff to deliver proactive reviews for high-risk patients.

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4. Impact of Exception Reporting Changes

Risk: Exception reporting thresholds may be tightened, meaning fewer patients can be excluded from QOF calculations. This could result in practices missing targets.

Key Takeaways:

  1. Ensure only clinically appropriate exceptions are used.
  2. Encourage patient engagement to minimise exception reporting.
  3. Monitor high-risk patient cohorts to improve adherence.

 

Steps to Protect Your QOF Income

  1. Identify At-Risk Indicators – Assess the impact of retired indicators.
  2. Optimise QOF Performance – Improve outcomes for high-value areas.
  3. Implement Robust Recall Systems – Engage patients to hit targets.=

Immediate Actions:

  1. Review QOF changes and update internal performance tracking.
  2. Train staff on optimising coding and documentation for new indicators.
  3. Ensure proactive patient management to achieve higher thresholds.

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