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Independents' Day

Local QOF replacement scheme frees GPs from ‘ticking all the boxes’

More than two thirds of GP practices in Somerset have ditched QOF for an alternative regional scheme and are already noticing the benefits of being ‘liberated’ from box-ticking.

The first three months of the Somerset Quality Practice Scheme pilots, launched in June after receiving belated NHS England approval, has seen 55 of the county’s 75 practices sign-up to the scheme.

The local LMC reports that the number could have been higher but delay in getting NHS England sign-off meant some GPs who had initially planned to take up the scheme had been forced to take ‘pragmatic’ steps and opt for the national QOF.

The deal allows practices to drop reporting of almost all QOF indicators – excluding a small set of ‘core clinical work’ – and instead they will provide quarterly reports on how the freed funding has been used to improve local services.

These locally developed schemes focus on three areas, integrating general practice with urgent care services, improving personalised care planning for patients with chronic conditions, and ensuring practice sustainability.

The CCG’s first quarter report on the scheme explains current initiatives include an enhanced primary care nursing support service for end of life patients in remote communities, and a risk identification scheme which has already halved avoidable admissions.

A spokesperson for Somerset CCG said: ‘Practices in Chard, Ilminster and Crewkerne are working with paramedics from the South Western Ambulance Service NHS Foundation Trust (SWAST) to support a ‘see and treat’ model of emergency care.’

‘With falls in the home still being one of the most common reasons for ambulance call-outs this collaborative approach has already halved the numbers of patients being taken to hospital by a ‘blue light’ ambulance.’

Dr Harry Yoxall, chair of Somerset LMC told Pulse: ‘The two things practices are reporting, is firstly: what a relief it is to not be looking constantly at the bottom right-hand corner of the computer, for the little QOF box saying “Tick me! Tick me! Tick me!”.’

‘And that has been very liberating. Colleagues are saying that it’s great and they didn’t realise how much they had been enslaved by the process.’

‘That’s the day to day benefit of stopping the reporting, because the GPs will continue to provide appropriate clinical services, just not ticking all the boxes’

He added: ‘And secondly: We’ve started to capitalise on some of those relationships [with other NHS and social careorganisations], and the CCGs report shows the kind of things that we’ve been talking about.’

‘They are by no means unique to Somerset. But we hope to make more progress than other areas, because they’re still preoccupied with the technicalities of QOF reporting.’

Several other areas expressed interest in replacing QOF with local schemes, though no more scheme’s will be approved until next year at the earliest, and Pulse reported in July that almost half of GPs would be in favour of dropping the QOF for a local scheme.

The roll out of locally developed practice quality initiaves has been backed by NHS England, but the GPC have warned it could undermine the nationally negotiated contract.

Readers' comments (5)

  • Vinci Ho

    Interesting 😑😳😗😽

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  • Why is the freed funding being used to improve local services? How do you measure how much if any is freed, the practice will still need to employ staff etc and the doctors need to be paid. So i am still not clear what they mean by freed funding?

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  • Discussing this with doctors dealing with falls patients and it is now clear that a fraility readcode is needed to stop patients over 75 being over prescribed medications for multiple co-morbidities when it may not be in their best interests to do so.

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  • You still have to do Qof work even if you don't tick it , eg get bp, cholesterol etc under control , and document it , except that now you won't get paid for it and have to take on extra commitments to earn that money back.

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  • Samuel Lewis

    not really sure - who's fooling who ? Are the CCG aiming to make savings here, or just divert 'GP' money to other work ? Will Quality and Outcomes start falling away from NICE standards. Will monitoring continue?

    GPs are not required to do QOF, but when they do they will tick only those boxes they please.. We get HCAs and Nurses to do most of it.

    low-tickers won't get paid much, but doubtless will assert that they have treated their patients to the highest of standards - they just cannot show it in the records.

    if the local CCG wants GPs to do other good stuff (Instead of or IN ADDITION ) then it should have drawn them up as Locally ENhanced Services within the nGMS national contract, under which GPs can do QOF or LES or both.

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