QOF Exception Codes (Personalised Care Adjustments - PCA’s)

Wednesday 4th Oct 2023

Following on from a few queries this month, we just wanted to touch on exception coding (or PCA’s as they are now known although we still all call them exceptions!!)

Previously QOF was 3 invitations to those on a register and then you could add the informed dissent code. Now, the general rule, where the disease area has the non-responder pathway built into it's ruleset, it is 2 invitations and upon appropriately coding both invitations, the patient will automatically be marked as a non-responder - obviously you can continue to extend additional invites and the patient can still be reviewed, however, the 2nd invite signals where your contractual obligation to inviting the patient ends.

Insight Members- there is a complete QOF Invitation Code 2023/24 Guide included on the members portal for you to download. This details all of the codes for each disease area. This can be found in:

QOF & Enhanced Service General Documents > England General Documents > QOF Invitation Codes 2023-24

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