Change in COPD cases having QoF reviews in KSS region, UK

Abstract

Kent Surrey Sussex (KSS) region in the South East of England has a population of 4.2 million. The KSS Respiratory Programme started in 2010, linked to the English COPD outcomes strategy. One aim of the program was to reduce the proportion of people with COPD who were undiagnosed. We developed a COPD Dashboard, and circulate this quarterly with commentary, so clinicians and managers can compare performance in key indicators. This is linked to educational sessions, a regular e-publication and advice to clinicians and commissioners. General Practices in England receive a proportion of income from the Quality and Outcomes Framework (QoF) which sets standards of care that patients should receive. It is possible to 'except' patients from the system if appropriate, e.g. terminal illness, however we noted variations in the number of 'excepted' patients. We were interested in looking at trends over time.

Change in COPD Registrations over time is shown. The number of registered COPD cases has increased in each of the counties with a total of 7,403 additional cases. There has been a highly significant reduction in COPD patients excepted from QoF assessments. The mean number of patients excepted in our 20 CCGs in 2010/11 was 13.9% and in 2014/15 it was 10.2% (CI for difference 1.7% to 4.6%, P<0.001, paired t test).Conclusion: In KSS from 2011/12 to 2014/15 there has been a 10.5% increase in the number of COPD patients entered on GP registers and a significant reduction in QoF exceptions. We believe these are important changes which have led to 8,845 additional patients receiving COPD reviews in primary care.