Overview of QOF/QAIF Audits

The new General Medical Services (nGMS) audits consist of Quality and Outcomes Framework (QOF) / Quality Assurance and Improvement Framework (QAIF) reporting lines, followed by non-reporting lines, the negatives and additional exception summaries.

There is a separate suite of data quality audits to support the QOF/QAIF Audits highlighting potential patients and helping you manage expiring exceptions.

Monitoring and Reporting Views

• Monitoring View - Displays the figures as they are currently, allows you to see how you are progressing. To access Monitoring View, from Audit Source select All Audits and nGMS Monitoring. The latest generation date is used as the reference date.
• Reporting View - The next 1^st April (1^st October in Wales) is used as the reference date, rolling forward each year. To access the Reporting View, from Audit Source select nGMS Reporting.

Audit Lines Structure

Audits consist of:

• Total Practice Population - The top line within each clinical category is the total practice population.
• Register - Each clinical category includes a register line, this displays on a purple/pink background. This is also referred to as the Virtual Register, as it is created from qualifying criteria. This register is not subject to exception reporting.
  
• Denominator - The Denominator displays purple text on a light blue background and represents the target population for that indicator:

  

  The denominator is made up of two groups:

  • Patients who are eligible and meet the criteria. For example, 'DM002 - Diabetic patients who have had a blood pressure check <=150/90 in the last 12 months'.
  • Patients who are eligible, who have not met the requirement, with any patients with exceptions removed. For example, 'DM002 - Diabetic patients who have not had a blood pressure check <=150/90 in the last 12 months'.
• Exceptions - Exceptions display as dark grey lines, these are patients who should not be counted towards the achievement percentages:
  

  

  Note - The light grey summary lines are not included in QOF/QAIF reporting.
• Numerator - The numerator displays in dark green text, and is also known as the Indicator. These are the patients that fulfil the criteria:

  

  The numerator line displays criteria for the achievement that can be made, for example, CHD005 (56-96%, 7 pts) shows that if between 56% and 96% of the patients eligible achieve the indicator, then 7 points are awarded.

• Negatives - Negatives lines, which display in red, display patients from the denominator group who do not fulfil the criteria:

  

  Note - Negative lines are not reported.
• Reminders - Negative lines have Reminders which, when activated, add a yellow post-it to the patient's record in Consultation Manager, to alert the clinician.
  

The Monthly Report

• The QOF/QAIF Report is the xml file transmitted to your country's reporting system which contains the mandatory reporting data generated from the nGMS clinical audits.
• The register, denominator, indicator and exception lines of the nGMS Contract audits automatically generate a report on the first day of each month.
• Data for a National Prevalence Day Report is taken from the QOF/QAIF Report submitted on the 31^st March of each year.

Daily Generation

• The nGMS audits generate daily.

Updates to the QOF/QAIF Audits

• New nGMS audits import automatically as part of a SIS upgrade. If this does not happen, they import on the last day of the month.
  
• Cegedim Healthcare Solutions re-author the nGMS audits to conform to the latest Dataset and Business Rules.