Abstract

Background
Annual Asthma Reviews (AARs) in General Practice (GP) require an assessment of asthma control, exacerbation history and management plans as part of the Quality and Outcomes Framework (QOF). When more AARs are completed correctly for those who need them, patients receive better care and the GP accumulates more points, allowing them monetary compensation for providing the service.

Quality Improvement Process
Multiple PDSA cycles were used, divided into 2 phases.
Phase 1:
1a) AARs from 01/04/21 – 31/07/21 were analysed to identify whether all the asthma review criteria were reviewed, documented, and actioned for each patient via the QOF template.
1b) When available, information from the notes was transferred to the template to satisfy QOF.
1c) If more information was needed, the patient was recontacted, and a new AAR was completed.
Intervention:
All GP staff members were updated during practice meetings of phase 1 results. Information was given as to where to access the AAR template, how to conduct a complete AAR and document this to satisfy QOF.
Phase 2
2a) AARs were analysed from 01/08/21 – 31/10/21 as previous.

Results
46% of AARs in phase 1a, 77% of AARs in phase 1b, and 94% of AARs in phase 1c were completed fully. In Phase 2, 100 % of AARs were completed fully in the first instance. This is demonstrated in Attachment 1.

Discussion
If the AAR is not correctly completed at the first patient encounter, as with 23% in phase 1, it sometimes needs to be completed again. This takes up both the patient’s and the clinician’s time and is not good practice. Additionally, 54% of AARs that were conducted did not satisfy QOF standards and therefore didn’t qualify for points or payment. Fortunately, post intervention, all AARs were completed on the first patient encounter.