Exclusive GP commissioners have begun paying practices that achieve efficiency targets through LES funding, in a sign that local versions of the Government's controversial quality premium are already in development.
The payments by one West Midlands commissioning group come as the GPC warned it would prefer to see no money at all spent on directly incentivising GP commissioning through the quality premium.
Stoke-on-Trent CCG has committed £1.15 per patient for ‘validating data and delivering QIPP outcomes that will be over and above the QIPP outcomes that will be included in the QOF'. The payments are delivered as part of a LES, drawn up ‘in the spirit of developing clinically led commissioning and shifting decision making and accountability from PCTs to CCGs', which also offers funding for pilot projects, commissioning masterclasses and backfill of GP time.
Sandra Chadwick, lead manager for Stoke-on-Trent CCG, said the LES was a ‘continuation' of one offered for practice-based commissioning: ‘It was adapted to reflect changes for the CCG and to ensure that there were no duplications in payments to practices with the new QOF indicators.'
But Dr David Wrigley, a GPC member and a GP in Carnforth, Lancashire, said: ‘If the LES is a precursor to the quality premium, it could be concerning in terms of the doctor-patient relationship. We all need to offer good quality, [but] there shouldn't be extra payments.'
At Pulse's commissioning roundtable last week, GPC deputy chair Dr Richard Vautrey signalled a toughening in the GPC's stance on the quality premium, and said GPs should be incentivised to commission through ‘peer pressure' rather than monetary reward.
He said: ‘I don't think there should be any extra funding. There shouldn't be extra money floating around or being handed out by the NHS Commissioning Board.
‘Success should be on what it delivers to its patients in terms of the clinical outcomes the Government is so keen on.'
