GPC attacks local moves to toughen QOF
The GPC has condemned a group of PCTs for attempting to judge practices on tougher targets than those agreed in the quality and outcomes framework, writes Lynn Eaton.
Last year Medway PCT disputed some practices' quality achievement scores, delaying their payments. Now the PCT, which is £1.5m in deficit, wants to redefine seven indicators in order to make them 'clearer'.
But GPs believe the PCT wants to toughen them to delay or reduce payments.Dr Laurence Buckman, GPC deputy chair, was adamant that the PCT had no right to do this.
'They can't rewrite any aspect of QOF payment or the way it operates,' he said. 'There is no room to make any change.'
Medway PCT has contacted neighbouring East Kent Coastal and West Kent PCTs to encourage them to adopt the same approach. Christine Greener, clinical governance manager at Medway PCT, said the three PCTs were working with the LMC to fine-tune the guidance.
'Everybody is in agreement that, to help GPs, they need much clearer guidance in order for them to meet quality guidelines as well as performance targets,' she said.
David Barr, clerk at Kent LMC, said that last year there had been a lot of disputes related to mental health data – such as what constituted a mental health review.
In a statement, Medway PCT insisted the aim was not to make the targets harder but to add clarity by specifying when things should be done in primary rather than secondary care.
But Dr Gary Calver, medical secretary of Kent LMC, said that it was not that straightforward. 'In trying to be helpful in explaining what was behind QOF, they have gone for higher standards than what the national guidelines required. We're obviously unhappy if they are going beyond the QOF standards.'
He added that the PCT wanted to integrate the rationale that explained the standards into the standards themselves. 'If the words they come up with are not in the legal QOF document, I think local GPs will be very angry,' he said.
Dr Hank Beerstecher, a GP in Sittingbourne, Kent, said he would take his PCT to court for breach of contract if they refused to pay him for working to the national agreement.
'If somebody owes me money and doesn't pay, that's what any business does,' he said. Dr Beerstecher added that the PCT would benefit financially from hanging on to the cash.
'As soon as they dispute your payment, they can defer paying you,' he said.The QOF is modelled on the primary care clinical effectiveness (PRICCE) scheme developed in East Kent.
But Kent LMC said the area was definitely not trialling tougher QOF indicators that would later be rolled out nationally.