ℹ️ Introduction
This article explains how to use Ardens Manager to review and understand QOF exception reporting. By the end of this article, you will be able to identify exception reporting activity, understand its impact on QOF achievement, and support appropriate use within your organisation.
Background
Exception reporting allows practices to remove individual patients from QOF indicators where it is not appropriate or possible for them to receive the required care or intervention.
This ensures that QOF outcomes fairly reflect the care delivered while accounting for clinical exceptions such as:
Patient choice
Clinical unsuitability
Informed dissent
Recently diagnosed patients or newly registered patients
Appropriate use of exception reporting is important to ensure:
Accurate QOF reporting
Fair measurement of performance
Protection of clinical decision-making
Data quality and governance compliance
How Ardens Can Help
Ardens Manager provides exception reporting insights within the QOF Dashboard to help practices understand where and why patients are being excluded from indicators.
These reports allow you to:
Review levels of exception reporting across indicators
Identify patterns or unusual levels of exclusions
Support governance and validation of QOF data
Ensure appropriate use of exception reporting processes
✅Included in Ardens Manager National Content package: Interested in finding out more or requesting a trial? Contact accounts@ardens.org.uk
📍Access Exception Reporting
Login to Ardens Manager
Select Contracts from the left-hand panel
Select QOF 2026-27
Navigate to the Personalised Care Adjustments category using the dashboard Filter
🔎 Review Exception Reporting
The Personalised Care Adjustment section provides a breakdown of patients excluded from QOF indicators.
Use this section to:
View which indicators have exclusions applied
Identify volumes of excluded patients
Understand the impact of exclusions on overall achievement
Support review of reporting accuracy
This helps ensure exception reporting is being used appropriately and consistently.
Understand Exception Reporting
Patients may be exception reported for a range of valid clinical and non-clinical reasons.
Common reasons include:
Patient declined care or treatment
Clinical contraindication or unsuitability
Recent diagnosis or registration
Patients not responding to invitations
Understanding these reasons helps ensure appropriate application of QOF rules.
Review Patient-Level Exceptions
Where appropriate, you can review individual patients who have been exception reported.
To view patient lists:
Click View next to the relevant indicator
Select the PATIENTS tab
Click the ? Check Patient icon (to the right of the NHS number)
Review exception reason codes and supporting information
To view trends in the application of exceptions:
Select the TREND tab.
Review the trend of the exception rates
Use this to:
Validate that exceptions are appropriate
Identify patterns in exception reporting
Support clinical and administrative review
Impact on QOF Achievement
Exception reporting can have a significant impact on QOF performance. It may:
Reduce the number of patients contributing to indicator achievement
Influence reported performance levels
Affect perceived prevalence and outcomes
Appropriate use ensures performance accurately reflects clinical reality.
✅ Good Practice
Exception reporting should always be used appropriately and in line with clinical judgement.
Good practice includes:
Ensuring exceptions are clearly documented in the patient record
Reviewing exception levels regularly
Avoiding inappropriate or routine exception reporting
Supporting transparency in reporting and governance
❓ FAQs
What is exception reporting?
Exception reporting is the process of excluding patients from QOF indicators where care is not appropriate or has not been possible.
Does exception reporting affect QOF income?
It can affect overall achievement by reducing the number of patients contributing to indicator performance.
Can any patient be exception reported?
No, exception reporting must follow defined criteria and be appropriately documented.
Should exception reporting be reviewed?
Yes, regular review is recommended to ensure appropriate and consistent use.
🏫 Additional Support
To further your understanding of the Ardens Manager platform:
Book training for your GP Practice, PCN or ICB
Complete the QOF academy module
Contact our Support Team for support in real time