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Locally developed QOF schemes should be encouraged, says commissioning leader

A senior commissioning leader has championed locally determined QOF schemes – as recently adopted in Somerset – as a way of offering care more suited to the local population.

Dr Charles Alessi, GP and senior advisor with NHS Clinical Commissioners, said that if the new CCGs could negotiate QOF deals more ‘suited’ to local needs then it should be encouraged, as he took part in a Pulse live Q&A discussion on Friday.

GP practices in Somerset were given the go-ahead from managers earlier this month to ditch QOF completely. The deal, struck between GPs in Somerset, the local LMC and NHS England will allow GP practices in the county to choose whether to continue working to QOF indicators, or opt for a new local contract funded with the funds released from QOF.

Dr Alessi, who is also chairman of the National Association of Primary Care, said: ‘If what Somerset has done with the QOF is something which is more suited for their population, it is something which we need to encourage. So no push back from me if it was done for the right reasons’.

In response to a question about seven-day access, Dr Alessi also said that GPs couldn’t be expected to be at work over the weekend because it was ‘unsustainable’ and should ‘embrace’ digital solutions as a way of meeting demands for increased access.

And he backed a reader’s assertion that a ‘real’ GP shortage was emerging, saying that simply recruiting more GPs wouldn’t solve the workforce crisis. He urged GPs to be more vocal about the improvements that were needed in practices to make the job more fulfilling.

He said: ‘The sadness is that we are also seeing youngish doctors retire because they are so overworked and fed up.’

‘We need to change this and describe a world of primary care where people want to keep working within. The way to manage this is for us not only to ask for more GPs but also to help describe how primary care will change to make our lives more fulfilling.’