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GPs buried under trusts' workload dump

We should try our best to retain QOF

Dr Binod Choudhary responds to a recent Editor’s Blog 

QOF cover image - January issue

 

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

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Readers' comments (2)

  • Ivan Benett

    I agree. QOF is the best way to address the ‘rule of halves’ for Chronic Diseases listed. Some places have suggested scrapping and using the money for other things. I disagree. We should be continuing with QoF AND resourcing things like work force expansion, extended Primary care and same day access for same day problems. The issue is overall under resourcing, bad long term planning and failure to match capacity with demand.
    Stopping QOF will be a retrograde step

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  • Where do I start! QOF was introduced with no evidence base, and has had no effect on outcomes according to the experts.
    It has increased workload massively and led to massive increases in expensive and dangerous polypharmacy mostly advised by Noctors who are not trained in pharmacology or EBM.
    It has led to a breakdown in trust between doctors and patients due to the conflicts of interest involved, and along with the CQC it has pushed many good GPs into early retirement.
    According to the latest European comparisons see the recent BMJ, we are now no 16 out of 35 in health care quality with one of the worst records on access, below Macedonia!

    If we are happy with that , then retain QOF.

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