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GPs go forth

CCG consulting on ditching QOF as practices take on secondary care services

Exclusive A CCG in the Midlands has started consulting member practices on options for QOF replacement schemes and how to make capitation payments to a new joint primary and secondary care organisation.

NHS Dudley CCG said it is not intending to abandon the QOF entirely but to overhaul it into a less ‘segmented’ system and align incentives with community and secondary care.

It comes as all practices in the CCG have joined the multispeciality community provider (MCP) vanguard, with a view to finalising proposals for a new framework within ‘a couple of months’, including working out the capitation payments they will receive.

Speaking to Pulse, chief officer Paul Maubach said the CCG, which has taken on delegated commissioning responsibility for general practice from NHS England, is looking to improve continuity of care for patients with long-term conditions via the measures.

Mr Maubach said: ‘We are actually looking at changing the QOF and all our enhanced services and putting a new framework together to deliver on the outcomes we are trying to achieve. We are going through that consultation process at the moment to make those changes with a view to implementing them from 1 April.

’We are looking at which conditions are most prevalent within our population and which we would like to achieve higher outcome ambitions for. That includes particularly hypertension and depression because they are common themes across the population.’

He added that the CCG is preparing for the establishment of the MCP, which is ‘unique’ in that all member practices will be part of it.

He said: ‘We are certainly looking at how you develop, along with the new care models, capitation budgets for the MCP model. That will include ultimately primary care within it.’

NHS Somerset CCG has just announced that the next step of its QOF alternative trial may be to pool QOF and enhanced services budgets with secondary care and community services, though Mr Maubach said this is not currently in the cards in Dudley.

Pulse revealed in December that at least 12 CCGs - including Dudley - wanted to replace the QOF, possibly undermining the national framework.

This followed pilots in Somerset, which began incentivising practices on local objectives last year. This scheme was declared a ‘success’ in April with the radical plans to pool incentives budgets unveiled last month.

Readers' comments (7)

  • Excellent idea to align QOF to CCG ambitions.
    They just need to be careful that anything that is removed from qof does not get sent back to secondary care.

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  • Excellent idea to align QOF to CCG ambitions

    Incredibly naive comment:

    see this presentation from the 'monitor' ideologue, slide 14.

    This is the first step is trying to dismantle GMS contracts and truly destroy general practice.

    If anyone thinks QOF will be replaced with something more reasonable, then may I suggest some therapy!!

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  • A "higher outcome ambition for depression"...and that would be measured by what exactly? Reduced diagnosis of depression? A "depression resolved" code?

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  • This is all part of the scheme to fragment the contract so that the already nearly useless GPC is completely neutered as it can't negotiate hundreds of local contracts, the money will then be wrapped up with other budgets so that the sums are completely obscured, the bureaucrats can divert money away from general practice and the LMC will have absolutely no clue what is happening as practices are starved yet further of cash.

    Divide and Rule.
    GPs are so so so utterly stupid to go along with this at a time when they need to stand together united more than ever in their history.

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  • Abolishing QOF probably means that the indicators will be moved - as the other "retired indicators" have been - into the basic contract.
    I asked HSCIC where the retired indicators were published: they haven't been yet
    "The business rules for ‘Indicators no longer in QOF’ (also known as retired QOF) v29.0/v29.1, upon which the data for 2014/15 (when published) will be based can be found on the HSCIC website at the following link:
    The data itself has not been published yet. *The HSCIC are in the early stages of planning how and when we will publish this data* (as well as other Enhanced Services datasets available on the Calculating Quality Reporting Services system) and publications will be pre-announced in due course here
    A link will also be included on this page to take you to the area of the website where the data are published."
    I suspect the results will be significantly worse than when this work was funded!

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  • GPs

    Please grow some and go private. That's what many of our generation are doing by getting on a plane. Well, part private and state in these countries. If you grew a pair and adopted the same things could improve. Its clear things will only get worse the way its going.

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  • Lets replace tick boxing with....errrrrrrr.....tick boxing.

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