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Cracking the cost versus quality conundrum

Dr Paul Zollinger-Read explains why QIPP will be important for GP consortia in his latest Note from the Dark Side.

Dr Paul Zollinger-Read explains why QIPP will be important for GP consortia in his latest Note from the Dark Side.


Over the past few months, I have met with many GPs involved in different stages of GP consortia development and one area that stands out like a sore thumb is that of QIPP. Nearly all GPs agreed they were not involved or had little knowledge of local QIPP.

So what is QIPP and why is it so important? Well, it's an odd term and originally stood for quality, innovation, prevention and productivity. It was a mini framework for looking at how we can deliver efficiency savings whilst maintaining or improving quality.

To put it in context, for NHS Cambridgeshire, if we do not alter the way we do things we will have a gap in our income and expenditure of approximately £100M after three years. This is similar for most PCTs and QIPP was a mini framework for how we approach this. We need to reinvest the £100m so that we can support the growth in our population and the development of medical technology… again this is similar across PCTs.

PCTs developed projects in many areas covering acute care, prescribing, mental health, primary care, community services etc. We are now revising these projects and have to make new submissions of our plans to SHAs. However, I sense a big disconnect from GPs and some PCTs.

It's crucial that these plans need to not only be understood by local consortia but also more fundamentally developed by them and delivered by them. QIPP isn't some add-on, it's the whole process by how we ensure sustainability in the way we fund care; if we don't crack this consortia will be immensely challenged. So make sure you're involved; if not leading QIPP locally. This is at the heart of why we want to develop consortia as local clinicians are best placed to make these decisions; fundamental decisions on the way we develop and deliver new models of care.

Finally, it is crucial that these plans adopt a 'system wide' approach; this is fundamental as there is no point in redesigning a part of a service in isolation. The first priority is to look at how we make the system more effective, then determine how this affects each organisation, and then to work through the financial consequences and supporting mechanisms required. This requires cross-organisational collaboration; these projects are very difficult to do but essential for the success of local consortia.

Dr Paul Zollinger-Read is a GP and chief executive of NHS Cambridgeshire

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