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QoF changes keep us running faster to stand still

Here we go again. For QoF, read trough – at least if you’re besuited and sitting on a committee. Because the view that the good old Quality and Outcome Framework is simply a GP income generator has just been reinforced with the news that certain indicators are likely to be retired.

Here we go again. For QoF, read trough – at least if you're besuited and sitting on a committee. Because the view that the good old Quality and Outcome Framework is simply a GP income generator has just been reinforced with the news that certain indicators are likely to be retired.

The logic goes like this. Most self-respecting GPs will already, every year or so, measure the blood pressure of their cardiac and stroke patients, the HbA1c of their diabetics and so on. So why pay them for doing so? Let's cut these indicators out, but instead of using the word stop, we'll say they're retired, as that sounds fluffier – as though they've done a good job and need a rest.

And guess what? We can replace those retired indicators with thrusting new ones – and keep the pool of points the same. That way those money-grubbing GPs aren't quids in, they have to work harder and we can bang on about quality improvement.

Hang on. I remember reading promises and reassurances from the BMA along the lines of "Undoubtedly there will be many requests for clinical and organisational areas to be added. This will only happen if they fulfil the principles of the framework and attract genuine additional resources." And I know this wasn't simply a pleasant dream, because I've just checked – it's a direct quote from the BMA.

Huh. In fact, QoF has simply become a mechanism whereby GPs can be squeezed ever tighter, with no extra reward. Far from being an income generator, it's become a treadmill where we have to run faster to keep still. Quality? No, quantity. Outcome? It may not just be indicators that retire.

Copperfield

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