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BMA will push for QOF to be 'retained but reformed', says new GPC chair

The QOF should be retained and reformed, despite the health secretary and NHS England saying its days were numbered, the new chair of the GPC has said. 

In one of his first interviews as GPC chair, Dr Richard Vautrey said that his intention for the contract negotiations with NHS Employers, due to start imminently, was that QOF should be ‘retained but reformed’.

But both Jeremy Hunt and NHS England chief executive Simon Stevens are pushing for the end of QOF, with Stevens saying the health service was 'committed in principle' to replacing it.

Previously, GP leaders have voted against retaining the framework, which led to many believing that the QOF would be removed in the next round of contract negotiations, especially after a working group involving the BMA and NHS England was formed to consider its future. 

However, GP leaders at the LMCs Conference in Edinburgh earlier this year voted that ‘disinvestment in QOF was no longer desirable', after expressing fears that the funding would be placed in new initiatives that would involve an increase in GP workload. 

Dr Vautrey has said that retaining the QOF against the wishes of NHS England would form part of the GPC's negotiating strategy.

He told Pulse that while there were still indicators they wanted to ‘review and change’, most of them now ‘mirror what we are doing on a routine basis’.

He added that he would watch with interest the steps taken by his Scottish counterparts in scrapping the QOF entirely, retaining funding at each practice’s baseline and introducing a new ‘quality review’ system.

But the priority for now is to ‘ensure that there’s some stability in the system, that the resources are there, that practice systems can continue. And that’s what we’ll be looking at in the coming year.’

He said: ‘We try to do the will of Conference. Conference wanted a retained but reformed QOF, and they set the mandate for GPC. There’s no will from the conference to do away with QOF all together.

‘But it’s a negotiation. We will wait and see what the results of that negotiation is - as we do any year. We will look at the whole package and try to get the best deal possible for GPs.’

At the end of 2016 the head of NHS England, Simon Stevens, said that QOF needed to be done away with entirely, saying it had ‘delivered the gains it is going to produce’ and had now descended into box-ticking.

Jeremy Hunt said about QOF indicators in 2014 that he would ‘remove the lot of them if he could’.

Readers' comments (5)

  • Liquidate Qof, put all the money in the global sum - have one global sum payment per patient for the whole country and give enhanced services where there is the need.
    We need more transparency in the system.
    BMA activists love the status pro quo and don't rock the boat for fear of themselves sinking.

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  • LMCs and BMA is one deep rut and hence the GPCs decision. Why did the GPC change it's mind in Edinburgh. These people take messages from LMCs and the same LMC bosses change their mind at the GPC conferences after having a drink?

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  • Of course we will not scrap QOF and receive it in the global sum - that is ridiculously optimistic. What will happen is that it will be replaced by something which is way more onerous and GP labour intensive - as opposed to QOF hoops being completed by our nursing team.

    I was at Edinburgh - I voted against scrapping it for these reasons. I have seen QOF replacement schemes in Somerset and quite frankly, I would take QOF any day

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  • Vinci Ho

    I can see the arguments from both sides but perhaps should also look at the actual price of QOF:

    'The value of a QOF point will increase by £6.02 or 3.6 per cent from £165.18 in 2016/17 to £171.20 in 2017/18.'

    For the sake of future negotiation, if people like Stevens and Hunt want more work to be shifted from secondary to primary care and daydream about this concept of 'one stop shop', our asking price of QOF will have to be substantially increased . QOF perhaps is merely a bargaining tool under such extraordinary circumstances......

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  • Be very wary about losing the QOF. We would still have to do the same work and be monitored on it. In the Next Steps on the 5YFV document (March 17) Simon Stevens says on page 21:

    "We will seek to develop and agree with relevant stakeholders a successor to QOF, which would allow the reinvestment of £700 million a year into improved patient access, professionally-led quality improvement, greater population health management, and patients’ supported self-management, to reduce avoidable demand in secondary care."

    ie the usual trick of removing funding and making us jump through new hoops to earn it back again whilst continuing to do the original activity....

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