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Practices could face £2,000 drop in this year's QOF income

Exclusive The value of the QOF work GPs are currently doing has not yet been decided, leading to fears that practices will lose out on payments worth up to £2,000 even if their achievement remains constant.

Pulse has learnt that the GPC has not negotiated an uplift to the QOF point for 2014/15 yet, which would be essential for practices to maintain their earnings due to increases in the average list size - which is used to ultimately calculate a practice’s payments.

NHS England committed to increasing the value of QOF points last year, but has refused to provide a similar commitment during contract negotiations this year, insisting on separate negotiations that are ongoing.

If GPC is unable to negotiate an further increase in the value of the QOF point this year, the average practice could lose out on around £2,000 for the QOF work they are doing this year.

The imposed GP contract in 2013/14 introduced a committment that QOF payments should be adjusted annually to reflect the actual average list size of GP practices.

At the time it said that the change would be ‘cost neutral’ because it was also increasing the value of the QOF point by the same proportion, reflecting the fact that a larger practice would be able to achieve more.

But Pulse revealed this week that the Health and Social Care Information Centre was mistakenly using the 2014 list size average for 2013/14 QOF payment calculations - when it should have been using the 2013 value - leading to GPs being told the wrong estimates of their QOF performance.

And in an even more serious twist, Pulse has learnt that NHS England has yet to agree to uplift the value of a QOF point to match the increase in practice list size in 2014/15 potentially exposing practices to QOF losses of £2,000 for the average practice even if their achievement remains the same as in 2013/14.

Official documents published alongside the GP contract deal show that the average patient list size has risen by 2% between 2013 and 2014, from 6,911 to 7,052, meaning that practices will also see the total value of their QOF achievement reduced by the same amount if there was no increase in the value of a QOF point.

GPC deputy chair Dr Richard Vautrey said: ‘There is an issue for 2014/15 in that, as you can see the value of each QOF point has not been increased to compensate for this year’s new average list size. This is because NHS England have insisted that this should be a separate negotiation from the just concluded contract changes for this year.’

‘There is a risk that unless this issue is resolved there will be small but annual losses to the value of QOF each year. This is unacceptable and we are pushing NHS England and NHS Employers to agree to resolve this.’

Commenting on the scale of concerns, GPC negotiator Dr Peter Holden said: ‘Because it was going to be cost neutral, they were supposed to also push up the value of a point. That was the deal. It was supposed to be automatic - that is what was agreed when they decided to change the CPI. Because if you reduce the argument to the absurd, if every practice in the country merged then the Government would be getting the entire QOF delivered for £120,000. My view is that if the Government is doing this, then it is straight deception.’

Dr Gavin Jamie, who runs the QOF Database website, said: ‘Even with the new, slimmer, QOF this decrease will wipe out the majority of the 0.28% [DDRB] uplift to GP payments this year.’

NHS England did not supply a comment despite repeated requests to do so.

Readers' comments (10)

  • What chance have we got when GPC cannot do the basics ...

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  • Vinci Ho

    Mistaken calculation, seriously ??
    How do we know it wasn't DELIBERATE calculation instead, huh??
    Peter, that was dirty tricks from NHSE , of course it is about 'efficiency saving' again !

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  • Maybe all surgeries should, on paper, split into 10 practices.

    I think the extra costs would be offset by the extra qof income.

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  • Oh dear. Stupid, incompetent and pathetic negotiation by our leaders! Did it ever occur to the negotiating team why the CPI changes where proposed in the first place from the previous arrangements? Add this to the financially deterimental way the vague 2014 "negotiated"contract changes are being interpreted locally, maybe next time we should probably just wait for an imposed contract. We might be better off! BMA nativity is unbelievable. Please get a professional negotiation team next time who can clearly work out the impact of proposed changes accurately and can see the pitfalls.

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  • Dear oh dear! Why on Earth are you still working in the UK? I thought the job was intolerable years ago so I emigrated. How much worse does it need to get before the rest of you leave? Words fail me...

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  • Collectivization of primary care continues.Thanks to the BMA and other commissars.

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  • When can the BMA actually tell us they negotiated something and the net effect is better for Primary care as the DOH got it wrong ( Except for the initial Gross miscalculation on expected achievement for QOF - which we have then had clawed back since).

    That was 10 years ago now, and every change since has been a claw back or cut in some form or another.

    Why do we have a one way unilaterally negotiated contract?

    Why can't all GPs announce from tomorrow, we will now (After a official consultation period of course!) - now charge the DOH £10 pound a consultation to recoup costs - as it is no longer cost effective to provide complete cradle to grave Primary care provision for £71 a patient a year.

    Lets get some more unilateral contract changes announced, and start billing them, as hospital trusts simply over achieve on their contracts and any surplus is paid over and above expected costs - and simply taken as efficiency requirements from the primary care budget.

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  • come on begin the mass resignation...set up a website so we can all express our interest

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  • Loss of £2000 more like £20000 - just because we are smaller than the new average. Disheartening when you see the amount before adjustment.

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  • GP contract in 2014/15 to benefit average practice by just £114

    Simply beyond words.

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