I read with interest the editorial entitled ’It’s the workload, stupid’. I have been working in primary care for the last few decades, and experienced many changes in the working pattern leading to quality improvement in the primary care.
In my thinking, and most GPs will agree, QOF is one of the most remarkable changes that has occurred in primary care leading to improvement in the treatment and the outcome of the chronic diseases. Most of the GPs and management staff will agree that it is a tool that has improved the care in the primary care and also gives an economy boost to cash-starved general practice.
QOF is one of the most remarkable changes that has occured in primary care
One thing I would like to remind our colleagues is that over the years, practices have learnt about the QOF system, and the IT experts have learnt the fine tweaking to redefine the denominators so that we can improve the quality of the care.
If the QOF is taken out of the system, I am sure we will be asked to do an alternative to improve the quality, which will be more difficult in an administrative sense. It would be more bureaucratic and less clinical quality-driven. One example is our Primary Care Commissioning Framework (PCCF), which is very time-consuming and does not necessarily improve the quality of the care in comparison to QOF.
In the current political climate, I don’t see that the global sum will be enhanced, so we should try our best to retain QOF. The financial value of QOF can be improved, and it can be changed accordingly, to meet the needs of the population and prevalence of the diseases.
Dr Binod Choudhary is a GP in Smethwick
