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PCTs told to use QOF funding shake-up to overhaul GP services

By Steve Nowottny

The scrapping of the square root formula is the ‘start of a new era' for primary care and will enable PCTs to merge practices and switch them to APMS contracts, NHS managers have been told.

A briefing drawn up by NHS Primary Care Contracting claims the QOF prevalence changes represent a ‘real opportunity for PCTs', and suggests trusts use it to prompt a wider shakeup of general practice in their area.

Managers in discussion with practices losing out under the changes should ‘point to the benefits to be derived from possible practice mergers or further cooperation in order for practices to benefit from economies of scale,' it says.

Losing practices could also be offered APMS contracts ‘which might secure their income but allow the PCT more opportunities to improve performance/quality/access' – a scenario described as a ‘win-win' for the PCT.

The document also urges PCTs to take a hard line in their negotiations with LMCs on how losing practices can be supported.

‘Do not suggest to the LMC that the PCT will offer LESs to compensate,' it warns, adding that a coordinated approach is essential because ‘LMCs talk to each other.' If trusts do offer to commission new services, such as a student LES, they should be ‘mindful of the precedent this could create.'

PCTs are also advised on how to win the PR battle relating to the changes, and urged to consider the ‘lessons learnt' over extended hours and the GP-led health centre rollout.

‘There is a risk that patients registered with the losing practices will be targeted by their GPs with adverse ‘noise' e.g. "our funding has been cut, so we have to sack our nurse or stop this service,"' it warns.

PCTs told to use QOF changes to force practice mergers and push GPs into APMS

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