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The three worst QOF indicators?

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I strongly suspect, though haven’t fully tested it out, that an anagram of ‘Quality and Outcomes Framework’ would be, ‘Which f***wit thought this pile of crap up?’ The second word definitely works.

In our practice, as in yours, we’re trying to shoehorn shedloads of frenetic box-ticking activity into the last couple of months of the QOF year. Patients are being recalled, jabbed, measured, reviewed, interrogated and so on just so we can squeeze the last bits of QOF juice out of them. Were it not for the fact that I have a mortgage to pay, it would make me feel thoroughly sick.

The grim reality is that, with stiffer thresholds, tighter deadlines and a whole circus-tent full of new hoops to leap through, it’s only going to get worse. In an effort to distract myself from this awful prospect, I’ve been trying to work out which QOF activity is most pointless/soul destroying.  There are so many to choose from.

My top three are, in reverse order:

3. CKD6, the need to check CKD patients for ACR/PCR in the last 15 months. Christ, what a faff: bottle, form, label bottle, fill out form, explain to patient, and for what? Six points and urine stains on the reception desk.

2. DEP1, the need to case-find depression in those patients on the diabetic and CHD registers using two standard screening questions. I confess, I cheat. I don’t ask the questions but I tick the boxes anyway. Take me to the GMC, I don’t care. I don’t need to ask them. One third of attenders are known to be depressed, and that’s before they’ve seen me. Guess what, you’ve got diabetes and/or CHD too, feel like celebrating? Of course they’re depressed. I’m depressed. We’re all depressed.

1. COPD10, the need to check FEV1 in patients with COPD in the last 15 months. Has this ever led to a change in management that wasn’t going to happen anyway? No. It’s literally a complete waste of breath. The truth is, an FEV1 check involves a patient blowing in one end and money coming out of the other.

God, this is demeaning and demoralising. If I could be permitted one further swear, I genuinely wish that those behind this process would, once and for all, f**k QOF.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.

Readers' comments (5)

  • Well said. It is all a load of tosh

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  • Couldn't agree more Eloquently describes exactly how I feel This politically led change to QoF benefits nobody in long term Dissatisfied, overworked and demoralised GP workforce who are bursting their guts already are expected to take on non evidenced based b''''''t to buy votes for this dishonourable shower who govern. Their long term strategy is fully apparent to all with half a brain! Make GP fully salaried service run by private providers. Their mates in big business who they share their bed with . I for one would retire if could afford to and would urge no young doctor to even consider GP as career. Stress and burn out with depersonalisation are real and happening to current GP workforce. When will this all end!

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  • Here here copperfield!

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  • Tears of laughter still on my face as I visualise the peak flow meter producing money at one end. It just about sums up the medical bankruptcy of the system. What is to be done? Where will it all end? Time to be who you are maybe?

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  • Perfect.
    DEP1 .... I cant bear it!!

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder