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Call to toughen QOF to raise GP productivity

The Government must ramp up targets in the quality and outcomes framework to make GPs more productive, the Health Select Committee has demanded.

In its report into workforce planning, released last week, the committee claimed productivity had fallen since the GMS contract was introduced.

It said: 'Workforce productivity is a vital goal that has been badly neglected', adding that the QOF 'should be used to negotiate more exacting targets for improving standards'.

'There is clear potential for the QOF to increase the productivity of the GP workforce by linking income directly with the achievement of specific objectives,' the MPs concluded.

Dr Laurence Buckman, deputy GPC chair, said the committee had shown 'a complete misunderstanding of what the QOF was for'.

'QOF is not a productivity tool. QOF is a method of delivering evidence-based care to patients. It's not there to produce exacting targets, it's there to deliver healthcare.'

Dr Buckman also disagreed that the new contract had reduced GP productivity.

Professor Bonnie Sibbald, an expert in workforce issues and professor of health services research at the National Primary Care Research and Development Centre, gave evidence to the committee that GPs were 'doing less and getting more'.

Her study, based on a survey of 1,000 GPs, suggested that average pay had increased by £15,000 a year for four hours less work per week under GMS.

Professor Sibbald told Pulse the survey findings did not in themselves prove that GPs were less productive, and other evidence indicated that the quality of care had improved. However she backed the proposal to toughen QOF targets.

'All other factors being equal, introducing more exacting targets should improve productivity,' she said. Dr Gary Calver, a GP in Folkestone and medical secretary of Kent LMC, said: 'It's a bit much for the select committee to now turn around and say because we've all worked a lot harder to achieve and improve, they now want to raise the bar further.'

The report also criticised 'reckless' expansion of staff, with the NHS recruiting twice as many GPs as planned between 1999 and 2004.

Dr Buckman said the extra GPs had been hired to meet Government targets. 'If you create meaningless targets designed to get the Government re-elected, you can't be surprised if managers do strange things under threat of dismissal,' he said.

What the Health Select Committee said

• 'The new GP contract may have reduced productivity'

• 'There has been a disastrous failure of workforce planning'

• 'The QOF should be used to negotiate more exacting targets for improving standards'

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