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'Increase quality framework thresholds to 100 per cent'

Quality framework thresholds should be 100 per cent to encourage GPs to 'chase down' the hardest-to-reach patients, a leading candidate for the NHS chief executive post is claiming.

Mike Farrar, who was lead negotiator for the NHS Confederation in the original contract talks, said not setting a 100 per cent level was his biggest regret about the deal.

He said: 'Having 90 per cent rather than 100 per cent at the top of most QOF bands means [GPs] can afford to leave the hardest 10 per cent and that's not good for tackling health inequalities.'

Mr Farrar, chief executive of West Yorkshire strategic health authority, said his other main regrets were the imbalance between physical and mental health in the QOF and the loss of sabbaticals for GPs.

But he rejected Government concerns over whether the contract had been value for money.

Speaking on the eve of the contract's two-year anniversary, he said the 'innovative and radical' deal had been of 'huge benefit' in primary care. 'My view is in the long-term people will look back and think this contract has been a very important influence on the way primary care is developed.

'It's cheaper to give someone statins and structured support for their heart disease than to have to perform bypass surgery.'

Dr Barbara Hakin, the current lead negotiator for NHS Employers, said analysis of QOF thresholds was 'a continuing process'.

Dr Laurence Buckman, GPC deputy chair, said GPs should offer the best standards of

care, but that 100 per cent thresholds should not be set.

'If you make everything 100 per cent, you force people to exception report.' He added: 'No audit operates on 100 per cent delivery.'

hcrump@cmpinformation.com

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