Introduction: Care home residents are frail, have multiple co-morbidities, experience polypharmacy and have limited life expectancy. The Quality Outcomes Framework (QOF) provides financial incentives for adhering to guidance for chronic disease management but does not usually account for multi-morbidity. In frail older people with multiple medical comorbidities, this may result in polypharmacy despite the risks of some treatments in a cohort with limited life expectancy often outweighing the benefits.
Salford Care Homes Medical Practice (SCHMP) is a novel GP practice with 921 registered patients all of whom are care home residents. Patients are registered on an electronic general practice record (Vision™) and placed on QOF registers as below.
Sampling methods: The SCHMP QOF database was interrogated and prevalence rates were compared with the national averages for GP practices in England (2011–12). The percentage of patients on each QOF register is presented below.
Conclusions: This survey demonstrates that care home residents are at higher risk of being on QOF registers than the general population potentially leading to inappropriate polypharmacy. Practices with high numbers of care home residents (or specialist services that deal only with care home residents) may face financial disadvantages or high levels of exception reporting as found in other studies [Shah (2001, BMJ, 342, 912)]. Commissioners should be aware of this and forthcoming NICE guidance incorporating multi-morbidity should be incorporated into future QOF targets.