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QOF Business Rules Coding Issues

Following the introduction of SNOMED, NHS Digital’s business rules team has been converting and mapping the READ and CTV3 codes into SNOMED, which has proved difficult and complex. Although there was always an expectation that there would be some errors as there are each year with the baseline version of QOF, a larger number than previous years have been detected:

  • 85 codes have been identified and queried from the v39 baseline QOF business rules from the total of 16,000+ that QOF uses (0.5% of all the codes).
  • Of these 85 queried codes 67 were incorrect and have been changed in v41 of the business rules
  • Those 67 codes impact on 12 registers from the 28 in QOF

It was therefore agreed that v40, the mid-year release, would not be implemented as new errors were continuing to be reported, and that v41 would be used instead. The revised v41 business rules will be published on the NHS Digital website next week and have already been distributed to suppliers. The affected registers are: Smoking, Dementia, Epilepsy, Heart failure, Asthma, Osteoporosis, Stroke, CVD, AF and CHD.

NHS Digital has confirmed that no final QOF Payment will be affected. However, until mid-February there may be some slight errors in some reports, but practices should be able to identify which ones may be suspect by using the attached spreadsheet.