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GPs told to ditch the QOF until April under radical agreement with NHS England

Exclusive GP practices are being told to ditch the QOF and focus on other local priorities after CCG leaders struck a radical agreement with NHS England to ‘switch off’ reporting their achievement for the rest of the financial year.

Pulse has learnt that GP practices in Somerset have been told by their CCG to stop reporting their QOF data and instead have been encouraged to participate in a CCG-wide project to ‘redesign GP services’ before April 2014.

CCG leaders have won an agreement with the local area team that practices will still receive QOF payments for January to March this year, but achievement will be based on the same period in 2012/13.

The move comes as the GPC also claimed Devon and Cornwall CCGs had negotiated an agreement with local LMCs to abandon chasing QOF points that would become redundant in April, in favour of making an early start on the unplanned admissions directed enhanced service (DES).

Both schemes mark a major break with the national contract, with CCG leaders encouraging practices to opt out of QOF work.

A letter from NHS Somerset CCG to all GPs - seen by Pulse - explains that the move to sideline QOF was needed to allow ‘thinking space’ to consider how to move more services into the community.

It says: ‘We have agreed with the area team, subject to practices support, that we can switch off the reporting of QOF for the first three months of 2014. The time freed up can be used to co-design changes in primary care delivery for April 2014 onwards.

‘The LMC has so far received confirmation from 70 practices confirming their support for the first three months’ work. The area team have confirmed their full support for the initial three month launch of this scheme. Participating practices may now safely stop reporting QOF for this year.’

The letter says that ‘good quality clinical care’ would mean that many of the activities under QOF will continue, but that practices should do this in a way that is ‘more focussed on patient’s needs’.

Dr Richard Vautrey, GPC deputy chair and a GP in Leeds, told Pulse the developments could set a precedent, with scope for LMCs in other areas to negotiate an early exit from QOF obligations in order to free up time for more productive work – but warned the plans in Somerset could backfire.

He said: ‘It is undermining a national contract locally. There’s a real risk that practices find themselves in the same situation that PMS practices now find themselves, where initially it sounds like a good deal to have more of a local contract with favourable conditions but it’s much more difficult then to get back to national arrangements if they find they are no longer getting favourable agreements and things have deteriorated.’

But he added that it was ‘sensible’ for GPs not to be tied now to their achievement on QOF indicators that would soon be removed from the framework, adding that this was the case in Devon and Cornwall where the CCG had agreed with the area team not to monitor the 341 points that would be removed from the QOF, but pay them in full in recognition of work to implement the unplanned admissions DES early.

He said: ‘It remains a big workload for practices to chase these points over the next two-and-a-half months. So there is still scope for doing this and starting work on an enhanced service that many people think will bring some benefits to patients.’

The new contract will see over a third of QOF removed from April 2014 – including a large swathe of indicators in the clinical domain worth a total of 185 points.


 

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Readers' comments (25)

  • Blimey and I thought common sense had deserted us, it may have a few pitfalls but its certainly a heads up for the rest of us. Quite inspirational from a PM's point of view.

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  • Does this mean that LATs have the power to alter/ignore National DH QOF requirements?
    If so, how far does this power extend? Premises? DESs? all other agreements e.g. GP IT support?
    *How will these local variations be monitored*?
    If I was a practice in an affected area, I think I would want a lot of detail - and very firm committments from the LATs and NHS England!

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  • I am getting confused-just what body is our negotiator
    in contractural matters? Divide and rule??

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  • What is the point in having plans - making them, endorsing them, building 5-yr business cases -- if they are then discarded at a moment's notice? Wouldn't we all be a lot better off if we didn't make any plans at all? It would waste less time.
    To put it another way - is the NHS being run as a true business, or merely by people playing at being in business?

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  • Peter Swinyard

    What happened to the NHSE "single operating model"? I am doing an afternoon of QOF code-checking rather than clinical work today. Can I stop please????

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  • Fascinating - but clearly not co-ordinated with other area teams!

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  • So Patients NOT seen since April 2013 can be ignored then??

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  • Resolve no longer to be slaves and you are free.
    Etienne de la Boetie (1530 - 1563)
    Discourse on Voluntary Servitude

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  • Does this apply to the Q&P indicators as well? Before I write the template!

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  • Of course the NHS is being run by numpties anonymous 2.35pm! Of course elaborately constructed plans can be halted at a moment's notice, so of course there is no point making them in the first place!

    What I am amazed at is the fact that these people actually believe that no jobsworth from NHSE will come along in April and demand all the QOF data anyway, just to keep themselves in a job if nothing else....

    Watch your backs guys...!

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