Quality and Outcomes Framework
The Quality Outcomes Framework (QOF), GP Practices and Fracture Liaison Services (FLSs)
Osteoporosis indicators in the QOF and FLSs are complementary. Together they create an integrated systematic approach to secondary fracture prevention bridging Primary and Secondary Care. This is in the best interests of patient care and will save health and social care resources.
- Osteoporosis indicators in the QOF present a real opportunity to improve secondary fracture prevention across the UK
- An FLS is a clinically and cost-effective service model for systematic secondary fracture prevention
- In areas where an FLS is in place, the service will support practices to achieve the quality of care required by QOF indicators
- In areas where there is no FLS, commissioning a service is recommended to improve the quality of provided care, support the implementation of QOF indicators and reduce the burden of fragility fractures on health and social care resources
- In areas where an FLS is not commissioned, implementation of the QOF indicators through other means by general practices is recommended
What is the QOF?
The QOF is the annual reward and incentive programme detailing GP practice achievement results. It rewards practices for the provision of quality care and helps standardise improvement in the delivery of primary medical services. It is a voluntary process for all surgeries in England and was introduced as part of the GP contract in 2004. The indicators for the QOF change annually, with new measures and indicators been retired.
QOF and osteoporosis
The following QOF standards are relevant to osteoporosis. They are available on the NICE website.
NHS England and the UK devolved administrations will use the NICE QOF menu to help decide which indicators are included in the QOF within their countries.
The contractor establishes and maintains a register of patients: 1. Aged ≥ 50 years and who have not attained the age of 75 with a record of a fragility fracture on or after 1 April 2012 and a diagnosis of osteoporosis confirmed on DXA scan, and 2. Aged ≥ 75 years with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis
View indicator details NICE id code: NM29
The percentage of patients aged ≥ 50 years and who have not attained the age of 75, with a record of a fragility fracture on or after 1 April 2012, in whom osteoporosis is confirmed on DXA scan, who are currently treated with an appropriate bone-sparing agent
View indicator details NICE id code: NM30
The percentage of patients aged 75 or over with a fragility fracture on or after 1 April 2012, who are currently treated with an appropriate bone-sparing agent
View indicator details NICE id code: NM31
Working together for effective patient care
Good communication between Primary and Secondary Care practitioners is vital to the success of secondary fracture prevention. Find out if there is an FLS in your area and talk to the providers about how you can work together to effectively reduce fracture risk in your patients. An FLS will be able to identify fracture patients at risk of osteoporosis, but as a Primary Care professional you have a crucial role to play in long-tern disease management.