COPD QOF Scores Query Raised by CQC 25 May 2016

COPD QOF scores – Query raised by CQC 25 May 2016

A query was raised about historic COPD QOF scores on MRC questions indicator

Our computer system does not allow examination of historic QOF results, only current ones.

The information from HSCIC shows we are on or above the local and national averages for most COPD indicators, so the only logical explanation is that we either did not code in the score, or did not do enough tactical exemption coding to manipulate the figures or that patients simply did not turn up for the checks and that those that did turn up were given better care than the national average.

Again, data analyses should also be carried out on the data without exception reporting to put any results in perspective, just like the diabetes queries.

Our system shows 2 of the 7 patients missing for MRC coding had relevant MRC codes in the last year and a recall that was not due yet. The other five have overdue recalls. So possibly there is a computer error that certain codes are not picked up, or the coding system is too complicated or some other technical computer related problem. The other five ‘missing’ are down to non-attendance of patients for reviews.

Our practice has the highest non-attendance rate for hospital appointments, so this is a feature of our practice population, not the practice, and is caused by us covering the most deprived ward in Sittingbourne and having had the highest rate of allocations for 12 years.

Just like the non-attendance for other reviews, we think it is disrespectful and unethical to coerce patients into attending by stopping their medications (suggested by CQC to improve the statistics of the practice). Patient care has to take priority over manipulating statistics for the CQC. Patient care has to take priority over checking computer codes used by the clinical system.

As the analysis for diabetes has been done by the practice, maybe CQC could see fit to do the proper analysis for COPD, referring to the methodology used by us, to produce results with an air of credibility? It is unlikely however this is going to make any difference to any patient, again time could be better spent by us than looking over statistical methods used by the CAC.