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GPs go forth

QOF should be scrapped under 'new deal' for GPs, says RCGP

The RCGP is calling on the GPC to ‘replace QOF’, and has urged the Government to conduct an immediate review of the ‘unnecessary burden’ posed by CQC inspections in a bid to relieve the immense pressure on GPs.

In its ‘blueprint’ - which details how the Government can deliver on the Five Year Forward View to overhaul the NHS - the college calls for an ‘urgent full scale review into how the bureaucracy, red tape and unnecessary workload’ can be reduced and how to free up GP time to focus on ‘delivering high quality patient care’.

It says that the QOF is creating ‘unnecessary burdens’ on GPs, and says there should be new funding arrangements to replace it.

The RCGP also says that there should be an ‘immediate review’ of the role of the CQC, following the calls from the LMCs Conference to scrap the regulator, and a speech by Dr Chaand Nagpaul calling for an end to the inspection regime.

The RCGP’s plan for general practice - released in May to coincide with the election of the new Government - stressed the safety implications of general practice being ‘significantly overstretched’, as GPs are unable to make necessary innovations to ensure future patient care.

It said: ‘There are concerns that general practice does not have the capacity to withstand a major health crisis such as a national flu outbreak, and that GPs who want to spend more time developing new models of patient care are prevented from doing so by current pressure levels.’

This could partly be achieved by a review of QOF and the CQC, it said.

The report called for the Government to ‘immediately initiate discussions with the GPC to replace the QOF with a new funding arrangement that allows GPs more freedom to focus on providing the best possible holistic care to patients and eliminates unnecessary bureaucracy’.

The calls come after several CCGs have initiated moves to replace the QOF locally as part of plans to co-commission primary care, while health secretary Jeremy Hunt has said he would ‘scrap QOF if I could’.

The RCGP similarly called for an ‘immediate review of CQC inspections and regulatory processes to eliminate unnecessary burdens for  general practice, and to ensure that scrutiny is focussed in those areas where it is likely to have most beneficial impact’.

It follows similar calls by Dr Nagpaul, who said the Government must ‘end the punitive overregulation that’s suffocating general practice - among the top four reasons why GPs want to leave the profession.’

He told the LMCs Conference last month: ‘We managed to get rid of the shameful intelligent monitoring bands, but still have practice ratings without context and circumstance, and which misleads the public with crude proxies that demean the holistic care hard working GPs provide.’

The blueprint also revealed that later this year the RCGP will publish ‘recommendations looking specifically at the patient safety implications of the rise in GP workload levels and the associated dangers presented by GP fatigue’.

Readers' comments (32)

  • Just go back to peer clinical governance and professionally motivated practice teams
    Throw away all the qof trash that treats our job as piecework and recording often irrelevant figures bearing little relation to good practice
    And please please gpc can you lead professionally on the basis of primary care scientific evidence and not endlessly collude with the latest government non evidence based schemery by prostituting gps to do anything for a fee? No wonder morale is low and many gps move abroad where they can practise as independent ethical professionals
    GPC NO MORE PROSTITUTING OUR PROFESSION

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  • Qof with stupid rules that don't take into account the over burden of medicines for the elderly should be scrapped, but registers to get people in and seen still need to be there.

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  • Vinci Ho

    As I said in the past , people can only be united when share the same enemy and hence objective, not the other way round;share the same objective merely for the sake of 'unity'. Hope GPC and RCGP can see it more clearly now.........

    There are only two cases in which war is just: first, in order to resist the aggression of an enemy, and second, in order to help an ally who has been attacked.
    Montesquieu

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  • Vinci Ho

    You see :
    For you guys in GPC and Chaand , you were bullied every year by the politicians when it came to contract negotiations on the table . Even DDRB's recommendations were literally trashed .
    And you guys in RCGP , DC got himself and his party out of jail denying that there was a GP crisis by exploiting what your chair 'naively' said about the best time to be GPs, hence earning points before the election . Don't you feel like you have been 'used' by Darth Vader?
    Who is your common enemy????

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  • I stopped my RCGP subs a while ago because of a lack of knowledge of what goes on in real general practice.

    Getting rid of QoF actually helps private companies who never do well on QoF as they are run by locums or salaried.

    QoF is extra work but we are used to it and actually it does improve patient care.

    We will end up having to do all the work anyway but do a lot extra to earn that money elsewhere.

    The BMA and GPC tap themselves on their back for reducing QoF last year and this but work has not decreased but increased.

    Getting rid of QoF means you still have to do the work.

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  • If the QOF is removed, the funding will also go. We will be invited to earn that money back by taking on yet more work, however, we will still have to hit all the old QOF targets as they are "evidence-based quality indicators", and this will be monitored by CQC / NHSE / CCGs. End result - more work, same funding!

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  • keep QoF; Otherwise I can already see practices cutting short cuts, not arranging or chasing the patients for the reviews. Secondly if QoF is relevant: diabetes rev, CHD rev then noone will complaint.

    was it GPPAQ etc were the irritating bit.

    In fact asthma action plan which educates the pt on mgt of asthma should be introduced in QoF. Havent we all seen patients who dont have a peak flow meter, dont know their best PEFR and have no clue on what to do when they get an exac.

    Certain elements of QoF are vital.

    worst fear: locally arranged criteria will be worse, postcode element to it and we will still be monitored for the current qoF indicators (remember the Organisational Indicators)

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  • here is how it will work out ... RCGP will call for QOF to be scrapped - government will say no as the public wants a way to measure VFM. RCGP will cave in and government will create QOF + (a national QOF and the + bit is for local additions to QOF).

    IF the rcgp and bma started modelling what will happen to the nhs if GPs all went private then I think you will get more interest and support from government, media and public.

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  • There are many changes required to make General Practice attractive to General Practitioners.
    The most important one to tackle the cause of depression amongst GPs which led to suicides.
    GMC MPTS should scrutinise complaint against GPs before torturing them to distraction or resignation.They should not automatically take complaints before intensely scrutinising them. Summoning GPs from London to Manchester to attended torturing,with GPs often unrepresented by doctors lawyers,as informed by Prof Brian Jarman in his celebrated editorial ' BMJ 2012;245:8239'when Managers rule [patients may suffer and they're the ones who matter has raised issued clearly.
    Prof David Michael Hands challenge to investigate bullying in NHS in his letter to Editor should be urgently taken up to save NHS. GPs should be encouraged to whistle blow to bring up our health service standards
    GPs mostly take their work as a service for patients which should be rewarded not by torturing hem to resignation.
    The Law says Innocent until proved guilty.So the above necessary steps by GMC to prevent suicides and depression recorded amongst GPs.
    Resilience training should be forced on GMC MPTS not to take hurting unsubstantiated claims against GPs

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  • Eureka .Finally RCGP and GPC are waking up. I have been shouting along with grass root GP's that to improve GP working conditions and recruitment and retention it is essential that we have a seven point demands
    1. Scrap QOF
    2. Scrap CQC inspections to Primary Care
    3. Make Appraisals 3 yearly and revalidation 7 yearly
    4. the over interference of Nice
    5. Scrap NHS 111
    6.Reintroduce basic practice allowance to improve recruitment of partners instead of salaried and locums
    7. Restrict meetings for GPs by CCG etc to one per month and abolish prescribing ,referral,locality meetings and free GP's time to see I'll or perceived to be ill patients

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