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GPs in limbo as PCOs drag feet on helping QOF losers

By Gareth Iacobucci

Almost a third of primary care organisations have yet to begin any talks with GPs over support for practices hit by the abolition of the QOF square root formula, a Pulse investigation reveals.

Even PCOs that have entered into discussions are in many cases dragging their feet and failing to offer firm guarantees that practices will be propped up when the first change takes effect in a fortnight.

Some practices are set to lose up to £100,000 a year under changes to the formula linking QOF pay to prevalence and the GPC has warned ‘tens or even hundreds' could face closure without financial support.

But GPs affected claim they have been met with a wall of silence from trusts and health boards, as they desperately seek deals to ease the impact of the losses.

Some are already preparing to cut services.

Pulse this week launches the No QOF Closures campaign to demand that PCOs provide parachute payments to all practices affected and that the Department of Health ramps up pressure on those that have made no efforts to do so.

Our campaign aims to gather messages of solidarity from GPs for practices hit by the changes, which although widely welcomed have left some – particularly those with young populations – facing sudden drops in income.

Pulse's survey of 65 PCOs found 29% had yet to begin discussions with practices or LMCs over support to QOF losers.

Only two PCOs have made firm offers of financial support for practices.

The lack of activity comes despite the DH asking PCOs back in October, when the changes were first announced, to work with GPs to ease their impact.

Dr Hugh Porter, a GP at the University of Nottingham medical centre, said his practice was likely to be ‘in the top two most affected' in the country but the PCT's initial sympathy wasn't resulting in concrete measures.

He said: ‘We're in negotiation with the PCT at the moment. They are broadly sympathetic, but that isn't translated into any action. Practices have had contact, but no answers. Their concerns have disappeared into the ether.'

Dr Porter warned his practice would be forced to make heavy cuts to sexual health, mental health and eating disorders services, and support for international students.

Dr Jennifer King, a GP in Sheffield at the university health centre, said her practice expected to lose ‘about £100,000' by 2010/11, but no support had been forthcoming: ‘We have made our PCT aware, but we're not getting phone calls or reassuring emails. They were supposed to be doing this in February. We'd like a dialogue rather than this total silence.'

Trusts indicated varying degrees of willingness to support affected practices.

NHS South Gloucestershire said it was ‘not proposing to support practices' after considering funding levels for those it thought would be adversely affected.

But NHS Eastern and Coastal Kent said it had already met with two practices likely to be most affected and was ‘committed to ensuring support is arranged by 1 April'.


Pulse has launched a campaign to ensure PCTs support practices whose existence will be threatened by the QOF changes and to ensure no practices go to the wall. Click here to sign up to our No QOF Closures campaign.

QOF list of shame

PCOs definitely not planning to support losers
• Heart of Birmingham PCT
• NHS South Gloucestershire

PCOs not yet in talks with GPs
• NHS Bury
• NHS Central Lancashire
• Croydon PCT
• Derbyshire County PCT
• Dudley PCT
• NHS East Sussex Downs and Weald
• NHS Hastings and Rother
• Hillingdon PCT
• Newham PCT
• Northamptonshire Teaching PCT
• Sandwell PCT
• Solihull Care Trust
• Telford and Wrekin PCT
• NHS Walsall
• NHS Waltham Forest
• NHS Warwickshire
• NHS Lothian
• Bridgend LHB
• Swansea LHB

Source: responses to Pulse survey

Pulse campaign: No QOF closures. Go to to sign up

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