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Independents' Day

Hike in QOF thresholds planned over two years

GP practices will have to work much harder for their QOF funding under Department of Health proposals to dramatically raise indicator thresholds.

The DH said it wanted to raise the upper thresholds for QOF indicators over a two-year period so that they are in line with the upper quartile of current performance.

It also said that this link would be maintained ‘in setting future thresholds’.

The DH said the move would ensure that more patients benefited from ‘best practice in areas such as keeping blood pressure low and reducing cholesterol levels’ and that it wanted to target those who were ‘hardest to reach’.

But the GPC warned the move would threaten individualised treatment for patients and could jeopardise patient care.

In a letter sent to PCTs and SHAs today, the DH said that the move was supported by research showing higher thresholds would save more lives.

The letter said: ‘The department proposes to raise the upper thresholds for QOF indicators so as to promote improvements in the numbers of patients who benefit from the evidence-based care reflected in the QOF.’

 ‘At present, these upper thresholds are below average achievement levels. Independent research has shown that, when the QOF was first introduced in 2004, it is likely that it reduced mortality by 11 lives per 100,000 people, but that providing the same interventions for all relevant patients could save 56 lives per 100,000 people each year.’

‘The department proposes to raise upper thresholds over a two-year period so that they are in line with the upper quartile of current performance and maintain that link in setting future thresholds.’

But GPC negotiator Dr Chaand Nagpaul said raising thresholds would risk patient care.

‘We are very concerned about the counter-productive effects of raising thresholds too high and the risks to patient care,’ he said.

‘There are reasons why QOF is designed to have thresholds at a certain percentage. It protects the patients from GPs simply trying to treat all patients the same, and recognises the fact that there needs to be some variability in the way we manage patients.’

Readers' comments (7)

  • Perhaps we should aim at the heart of the matter. Who are the doctors advising the Dept of Health about changes to QOF? Why are they getting it so wrong? Are they primary care physicians? If not, then why not? If they are academics residing in ivory towers then they are not qualified to make these recommendations. Recommendations should come from the RCGP with input on the business side from the BMA. In other words WE should be advising the government what is best for OUR patients, they should not be dictating to us what will happen. I really think that this represents the last straw. The balloon is about to go up.

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  • I am not your patient - you are my Doctor. I do not exist for your benefit you are there to serve me as and when I need advice.That is what all this is about. The DoH (politicians) do not like professionals calling the shots.

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  • Its all very well making remarks as above but when it really comes to taking concrete action doctors are poor at doing so and feeble attempts like the one with pensions only strenghthens the MPs resolve to break GPs down and dictate terms to us

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  • Freedom of Inofrmation do to try to ascertain which doctors are advsiing the DH, what the evidence is and how patient autonomy will be maintained to ensure that patients are aware of their rights to be Exception Reported. The Freedom of Inofrmation request is here:

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  • The government wants to reduce the money it pays to hard working GPs, the lower classes, those on benefits etc etc as they are less likely to fight back but is happy to fund banks supplying PFI contracts, allowing petrol to be stupidly taxed, allow the super rich to avoid tax, etc etc. It like stealing from the poor to feed the rich. Its happened since the begining the time.

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  • What happened to the days when patient's health was of the upmost importance? Now practices are desperately jumping through hoops to keep income in order to remain in existence. Targets are all very well and good but each patient is an individual and has the right to be treated as one. I hope the government has a good contingency plan as at this rate GP's will rapidly be disappearing due to the constant cuts in funding.

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  • Who draws up the `NICE guidelines? These do not allow patients to be treated as individuals.

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