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GPs told to ditch the QOF until April under radical agreement with NHS England

Exclusive GP practices are being told to ditch the QOF and focus on other local priorities after CCG leaders struck a radical agreement with NHS England to ‘switch off’ reporting their achievement for the rest of the financial year.

Pulse has learnt that GP practices in Somerset have been told by their CCG to stop reporting their QOF data and instead have been encouraged to participate in a CCG-wide project to ‘redesign GP services’ before April 2014.

CCG leaders have won an agreement with the local area team that practices will still receive QOF payments for January to March this year, but achievement will be based on the same period in 2012/13.

The move comes as the GPC also claimed Devon and Cornwall CCGs had negotiated an agreement with local LMCs to abandon chasing QOF points that would become redundant in April, in favour of making an early start on the unplanned admissions directed enhanced service (DES).

Both schemes mark a major break with the national contract, with CCG leaders encouraging practices to opt out of QOF work.

A letter from NHS Somerset CCG to all GPs - seen by Pulse - explains that the move to sideline QOF was needed to allow ‘thinking space’ to consider how to move more services into the community.

It says: ‘We have agreed with the area team, subject to practices support, that we can switch off the reporting of QOF for the first three months of 2014. The time freed up can be used to co-design changes in primary care delivery for April 2014 onwards.

‘The LMC has so far received confirmation from 70 practices confirming their support for the first three months’ work. The area team have confirmed their full support for the initial three month launch of this scheme. Participating practices may now safely stop reporting QOF for this year.’

The letter says that ‘good quality clinical care’ would mean that many of the activities under QOF will continue, but that practices should do this in a way that is ‘more focussed on patient’s needs’.

Dr Richard Vautrey, GPC deputy chair and a GP in Leeds, told Pulse the developments could set a precedent, with scope for LMCs in other areas to negotiate an early exit from QOF obligations in order to free up time for more productive work – but warned the plans in Somerset could backfire.

He said: ‘It is undermining a national contract locally. There’s a real risk that practices find themselves in the same situation that PMS practices now find themselves, where initially it sounds like a good deal to have more of a local contract with favourable conditions but it’s much more difficult then to get back to national arrangements if they find they are no longer getting favourable agreements and things have deteriorated.’

But he added that it was ‘sensible’ for GPs not to be tied now to their achievement on QOF indicators that would soon be removed from the framework, adding that this was the case in Devon and Cornwall where the CCG had agreed with the area team not to monitor the 341 points that would be removed from the QOF, but pay them in full in recognition of work to implement the unplanned admissions DES early.

He said: ‘It remains a big workload for practices to chase these points over the next two-and-a-half months. So there is still scope for doing this and starting work on an enhanced service that many people think will bring some benefits to patients.’

The new contract will see over a third of QOF removed from April 2014 – including a large swathe of indicators in the clinical domain worth a total of 185 points.


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Readers' comments (25)

  • Unfortunately the press coverage of our project has been misleadinq - Somerset practices have not been told to ditch anything, but offered an opportunity to have some time to think about how general practice can be made more sustainable in the long run. Most have taken up the offer of a three month QOF pause , others prefer not to, which is fine. Nor is the LMC abandoning national negotiation. The payment for this voluntary alternative to the voluntary QOF remains directly linked to the GPC & NHS Employers agreement for each of the potentially affected years. Somerset is a very fortunate health community with one LMC and one CCG covering the old county PCT area and a long history of very good working relationships between all the parties. We also have visionary senior management at our Area Team who are keen to work co-operatively with primary care, and we trust them to keep their word. We do not know if we can build something to use in 2014 -15 as a pilot for a genuinely new way of demonstrating practice quality, but given the besetting problems of the NHS all the participants - LMC, CCG & Area Team alike - thought we should give it our best shot. Harry Yoxall, LMC Medical Secretary

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  • I think it is a really good idea, as long as it remains voluntary.

    The CCG should be applauded for thinking outside the box to make things work. The goodwill will also help massage any radical changes which result from this consultation. Someone in charge of 'Christmas Eve Rules 2014' at NHSE needs to take note.

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  • would be great not to have to complete the pointless QP reports that are needed at the end of the year saying what useless pathways you have invented and followed

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  • I'm Tired of waiting around for BMA or GPC to help. What part of the QOF changes for 2014 will free up GP time? I'm still waiting for a sensible answer. The system is about to fall over and GPs are exhausted. I'll take the chance of moving away from a national contract ( although that's not what is envisaged) and ditch the box ticking accounting tool that QOF has become. Our patients deserve better......

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  • QOF was developed as a mechanism to pay us more whilst seemingly getting something in return . It was done to avoid a workforce crisis . Now we face another crisis despite QOF.

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