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From Backlog to Breakthrough: How We Supported a PCN to Achieve a 16.8% Average QOF Improvement in Just Four Months

Two healthcare professionals sat in a GP Surgery talking


Background


In 2024, a Primary Care Network (PCN) made up of 10 practices approached our team with only a few months left in the year to meet long-term condition (LTC) and QOF targets.

We rapidly deployed 10 pharmacists who worked across core QOF indicators, exceeding targets in the priority areas ahead of schedule and freeing capacity to support in additional clinical areas.


Later that year, the PCN asked us to help tackle a backlog of structured reviews in hypertension, diabetes, coronary heart disease (CHD), heart failure, asthma, COPD and more.


The Challenge


With hundreds of patients awaiting review, the PCN needed immediate expert support to clear the backlog and protect QOF performance.


At the same time, they were keen to avoid a “quick fix” that would leave them with the same pressures the following year. They needed:


  • Short-term impact to address the backlog quickly

  • A sustainable model that could be embedded into everyday practice

  • Assurance around quality, governance and consistency across all 10 practices


Our Intervention


Our team delivered 8,327 structured LTC reviews across 25 QOF indicators, taking the pressure off practice teams and creating headroom for GPs and nurses.


These reviews covered all key LTC disease areas, with outcomes carefully:


  • Recorded in the clinical system

  • Optimised in line with local and national guidance

  • Aligned with QOF requirements and recall processes


From the outset, we worked with the PCN to design a scalable, sustainable model, rather than a one-off backlog clearance exercise. The focus was on consistent processes, shared standards and repeatable workflows that practices could continue to use beyond our initial involvement.


Outcomes and Impact


The project delivered clear, measurable benefits for the PCN:


  • Reviews completed: 8,327

  • QOF uplift: +16.8% average (from 66.8% → 83.6%)

  • Highest single-practice uplift: +30.6%

  • Sustainable model adopted, with investment in full-time pharmacist cover

  • Workforce development programme launched, including mentoring for three pharmacists and one pharmacy technician


By combining high-volume delivery with clinical governance and shared learning, the PCN achieved stronger QOF performance and a more resilient approach to LTC management.


Alignment with NHS Priorities


This work closely aligns with key NHS priorities and the ambitions of the NHS Long Term Plan. The model supported the PCN to:


  • Improve LTC management and contribute to reduced avoidable admissions

  • Make best use of ARRS funding through high-impact clinical roles

  • Free up GP capacity via effective multidisciplinary working

  • Tackle health inequalities through proactive outreach and structured reviews


Conclusion


This project shows the difference that embedded, expert pharmacy teams can make:


  • Stronger QOF achievement

  • A sustainable, scalable model for LTC delivery

  • Better, more consistent care for patients with long-term conditions


Rather than simply clearing a backlog, the PCN has laid foundations for ongoing improvement, supported by a growing, skilled clinical workforce.



QOF Indicator Improvement

Bar chart to show QOF Indicator Improvement

Testimonial


“The pharmacist service has been instrumental in helping our practices achieve strong QOF outcomes through consistent, high-quality clinical input. Communication has always been clear and proactive, and their integration with our practice teams has been seamless.”— PCN Manager

If your practice or PCN is facing similar challenges with LTC backlogs, QOF improvement or workforce capacity, we would be happy to explore how we can help.


Book a call with our team or visit our website to find out how we can provide similar support for your practice or PCN.


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