QOF Exception reporting; Quick reference guide to terms used

For a fuller explanation of exception reporting, please refer to one of the Questions & Answers documents prepared to accompany the tables for

• 2006/07
• 2005/06  

Registers
The number of patients within each of the QOF clinical indicator groups, as reported for 14th February (National Prevalence Day).

Denominator
The number of patients for whom the QOF points for the indicator could reasonably have been obtained.  Denominators for clinical indicators are subsets of the relevant registers, with some patients excluded due to the indicator definition, and some patients exception reported on the basis of defined criteria.

Numerator
An indicator numerator is the number of those in the denominator who meet the specific indicator success criteria.

Exclusions
Patients who are included on a particular register, but for who for definitional reasons, cannot be included in a specific QOF indicator denominator.  For example, an indicator may refer only to patients of a specific age group, patients with a specific status (e.g. those who smoke), or patients with a specific length of diagnosis.

Exclusion rate
The number of exclusions, as a percentage of the number of people with the condition on 31st March.  This may differ from the National Prevalence Day register due to timing.  Calculated as:  exclusions/(exclusions+exceptions+denominator) x 100.

Exceptions
Patients who are on the disease register, and fall within the indicator definition, but are not included in the indicator denominator because they meet at least one of the exception criteria outlined in the GMS contract.

Exception rate
The number of exceptions as a percentage of the number of people eligible to be included in the indicator denominator, i.e. calculated as exceptions/(exceptions+denominator) x 100.

Note on comparisons of practice exception rates
Rates should not be compared in isolation, but considered in conjunction with numbers of patients involved, because some rates are based on very small numbers.  For example, an exception rate of 50% would be less significant if 1 of 2 patients was excepted than if 250 of 500 were excepted.