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Talks breakdown threatens new QOF areas

The GPC's offer for two new clinical areas – osteoporosis and peripheral arterial disease – to be added to the QOF has been thrown into jeopardy by the breakdown in contract negotiations.

Talks between the GPC and NHS Employers broke down dramatically yesterday over the terms of funding for extended access, leaving plans for a series of new clinical points hanging by a thread.

The GPC proposed moving points from the organisation and holistic domains to the two new clinical domains, a new heart failure indicator and to the chronic kidney disease domain – in response to criticism that its points did not reflect the workload.

In his letter to GPs, GPC chair Dr Laurence Buckman wrote: ‘Up to 38.5 points from the organisation and holistic domains were identified as points the Government no longer wished to purchase and were to be allocated to new clinical areas or to enhance existing areas.

‘This would have included delivering two new clinical areas – osteoporosis and peripheral arterial disease – plus expanding the scope of ethnicity monitoring, a new indicator covering the treatment of heart failure, enhancing the point value of chronic kidney disease and changes to existing areas in line with the recommendations of the expert panel.'

He continued: ‘The Government stated that the 38.5 points identified in the organi-sation domains and the holistic points of the QOF should all be given to support these new access arrangements, bringing the total of QOF points related to access to 58.5.

‘This, in fact, would be sacrificing evidence-based potential new areas of work that would have saved lives and provided improved quality clinical care to patients, in exchange for non-evidence-based, Government-driven, politically-motivated access targets.'

The GPC is now awaiting the Government's next move, expected to be giving notice today of a 13-week period of consultation about the plans.

Dr Peter Stott, a GP in Tadworth in Surrey and a member of the National Os-teoporosis Society, accused the Government of trying to create dissent amongst GPs.

‘The QOF was always intended for clinical matters. Some of the administrative things could quite easily be done away with to introduce osteoporosis and peripheral arterial disease, and the NOS would have welcomed that.

‘But new clinical areas and access don't necessarily have to be linked. It doesn't have to be one or the other, but it so often is with Government negotiations. Extended access shouldn't be linked to the QOF – there should be DESs and LESs to encourage people to do out of hours services.'

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