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Gold, incentives and meh

GPC warning over plans to rewrite QOF

By Steve Nowottny

Government plans to tear up and rewrite the QOF could be pushed through despite the objection of GPC leaders, Pulse has learned.

The warning from the Department of Health follows a major attack by GPC leaders on the Government's blueprint, which would see NICE radically reshape the QOF on the basis of cost-effectiveness from next April.

Under the plans, almost the entire QOF will be reviewed for cost-effectiveness, while NICE will also develop and pilot 10 new indicators a year, to be negotiated on by the GPC and NHS Employers. PCTs would also be given the flexibility to choose some local indicators from a national menu.

But the GPC's submission to the Government's consultation is expected to outline a range of serious objections, after GPC leaders discussed the proposals at a meeting last week.

GPC negotiator Dr Chaand Nagpaul said: ‘There was an element of disbelief that the one jewel that most of us would agree is in the crown of the new GMS contract is actually being looked at as if it needs to be somehow radically altered.'

‘We believe this is a system that has worked and should be supported – and not tampered with.'

Negotiators said they had ‘huge concerns' over the proposals for local QOFs, and said that the blueprint's intention to leave access indicators outside NICE's cost-effectiveness review was ‘quite bizarre.'

GPC chair Dr Laurence Buckman added: ‘The idea that you could have a proscribed number of indicators that fall off each year and other ones that come in each year because you don't need them because they're all incentivised is nonsense.'

But the Department of Health this week warned that the GPC would not be able to veto the proposed changes, saying only that it would ‘discuss with the GPC and other professional and patient groups how the new proposals should work.'

A spokesman said: ‘There is no need for a statutory change to introduce a new process for setting indicators. The choice of QOF indicators and level of payment will continue to be a matter for consultation between NHS Employers and the GPC. It will not be a matter for NICE.'

Dr Nagpaul said the GPC would be responding ‘in vigorous terms' to the consultation, and that it was ‘premature' to second-guess the Government's response.

‘Obviously the Government is able to change any legislation it wanted to, it's done that with extended hours and all the rest, but we're certainly not going into it with an expectation or conciliatory approach of expecting major changes to QOF.'

GPC member Dr Kailash Chand urged negotiators to take a tough line in their response.

‘It's time to stand up and be counted against bullying, which is what this is,' he said. ‘Giving control to NICE would be totally against the ethos of the contract.'

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