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GPs go forth

LMCs vote to keep QOF despite concerns over patient-centred care

GPs at the LMCs conference have voted against scrapping QOF - despite agreeing on concerns the scheme does not allow enough scope for individual, patient-centred care.

Conference voted against calling QOF ‘unfit for purpose’ and for the scheme to ‘be scrapped with the money transferred into the global sum’.

However, LMC representatives supported other parts of the motion, put by Cleveland LMC, declaring much of QOF ‘does not recognise the increasing stratification of management of long-term conditions dependent on the patient’s general health status and co-morbidities’ and ‘does not reflect current concepts of patient choice’.

Proposing the motion, Dr Julie-Ann Birch argued that numerous studies ‘have shown QOF has damaged patient-centred, holistic care’.

Dr Birch said: ‘QOF has undermined our professionalism and reduced patient choice as we all strive to fit patients into boxes rather than respecting their individualism.’

She added:’Practices are under severe pressure as we’ve been hearing all day. We need to reduce the burden of administration and increase the level of secure, predictable income for practices. Let’s get rid of the straighjacket of QOF.’

However, Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee said he ‘huge sympathy’ for much of the motion, QOF largely represented good clinical care, allowing for exception reporting, and warned delegates that there was no guarantee QOF funding would be retained elsewhere.

Dr Green said: ‘Most of it is good care. If you pass [this] you are opening the door to QOF being scrapped but without any guarantee the money will be going into the global sum.

‘Even if it does you have to be aware of the… consequences - that is there will be a significant flow of money away from high-achieving practices who have invested to low-achieving practices.’

Motion in full

That conference contends that much of the remaining QOF:

i) does not recognise the increasing stratification of management of long-term conditions dependent on the patient’s general health status and co-morbidities

ii) does not refflect current concepts of patient choice

iii) is unfit for purpose

iv) should be scrapped wiht the money transferred to global sum


Related images

  • LMCs Conference 2015

Readers' comments (1)

  • Samuel Lewis

    Let us now improve QoF, not bury it.

    How can we encourage patient-centred care, AND remain evidence-based ?

    Can we develop exception-reprting, so that gaming is reduced, and 'informed dissent' say to Statinisation, is properly valid. Why can't side-effects, allergy, and contraindications be logged under 'patient unsuitable' ?

    We could extend QoF to answer such Research questions as we believe matter. eg 'how many people on statins complain of side-effects' and does it relate to dose or CVD risk? How about some data-gathering on what works in multimorbidity ? eg: does aspirin benefit the diabetic with a heart attack, or not? and do they really have a lower cancer incidence and mortality ??

    All the reasonable objections to QoF straitjacketing can be incorporated into evidence-based incentivised care... Ideas please for QOF+

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