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Nagpaul: We aim to shrink QOF further next year

The GPC is aiming to negotiate further reductions in the size of QOF from next April, chair Dr Chaand Nagpaul has revealed during an interview at Pulse Live.

Dr Chaand Nagpaul said that he was keen to reduce the burden on GPs and that part of that would be making QOF much smaller.

His comments come after health secretary Jeremy Hunt said the reduction of QOF targets in this year’s GP contract did not go far enough, telling a conference that he would ‘remove the lot of them if he could’.

Dr Nagpaul was speaking during an interview at the Pulse Live meeting in Manchester about his first year as chair, and his plans for the next GP contract.

He said that his main achievement had been was bringing the Government back onto the policy-maker negotiating table - following the 2013/14 GP contract imposition - and achieveing a 40% reduction in QOF.

He also said: ‘One of the most important things for me was to actually get back onto the negotiating table and I think in that regard, if you actually reflect, probably about 80 or 90% of the imposition, which months earlier we were told was non-negotiable, actually has now been scrapped… I don’t think we have got as far as we would like to, but I think it is a start to actually have negotiated a reversal on policy.’

Asked whether QOF will shrink even further next year, Dr Nagpaul said: ‘That is precisely what we would like to do. We would like to make sure that QOF complements good clinical care, doesn’t add clinical burden.’

He added: ‘What has happened is that QOF became a monster and we have now actually scaled that back and we would like to do more of that. I think it is right to have clinical standards, but clinical standards that are actually relevant, not just add bureaucracy.’

He said that while GP workload was still growing, a lot of that was not because of the GP contract, but because of other factors.

He added: ‘I think it is very hard to look at the contract in isolation. GPs are suffering workload from all quarters, and much of it doesn’t relate to the contract. For example the swathes of work that is moving out of hospitals into GP consulting rooms in an unresourced manner, the increased demands on our time from an ageing population - these sort of things are not related to the contract.’

Dr Nagpaul did not rule out a proposal from one new BMA Council member orchestrating a mass resignation from the profession over pay, but said the profession currently did not support it.

He said: ‘It is not so much about my opinion, it is about what the profession wants. The last thing that any of us needs is to put up an idea that isn’t going to be supported by the profession. To have any impact you would need to have some confidence that the profession at large would actually follow suit. We had an event recently, the LMCs met, and there certainly wasn’t any mood for undated resignations. If that is what I am being told by the mass of GPs, then obviously as a leader of profession I will respond to that.’

Readers' comments (12)

  • This stinks of 2003!!! The overfunded with low disease prevalence & low levels of deprivation will gain again from the loss of MPIG.
    As a practice with high deprivation, no MPIG and over the scale levels of disease prevalence how did we gain so little last year.
    It is time pulse really added up the figures of last years contract.
    Shame on you GPC your agenda is obvious.

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  • "Dr Nagpaul did not rule out a proposal from one new BMA Council member orchestrating a mass resignation from the profession over pay, but said the profession currently did not support it."

    Errrm who says the profession does not support mass resignation Dr Nagpaul? At the last count you haven't actually asked anyone!!

    The GPC/BMA have consistently avoided asking its members whether they would want to exit the NHS under unparalleled workload pressure and low morale.

    The GPC really is a total waste of time if it cannot gauge the strength of feeling of its members (and those who have already cancelled membership). Perhaps if every GP who wants a referendum or open debate on exiting the NHS cancelled their BMA membership the council would take note...

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  • 7:02pm I agree! Just asking at the LMC conference recently is NOT asking the actual GP workforce whether we have an appetite for mass resignation or not. Nor is just asking BMA members- i left the BMA recently due to being disillusioned with it. Only when we are all asked will I accept the response as that of GPs. We are coming up to an election and we need to use this to our advantage to show our frustration at the demise of general practice. If the GPC/BMA/RCGP don't action at the right time then they are also responsible for the demise of this great profession !

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  • Vinci Ho

    It is a shame this saga of QOF has been politicised from both ends of the negotiating table,especially QOF was created by Labour government.No doubt the 'prize' to claim here is 'successfully reduced bureaucracy in general practice'.
    The real issue ,however,is the funding of indivual practice.. The truth is increase in workload is not entirely down to QOF . There is also a crisis in secondary care which consciously and subconsciously 'downloaded' a lot of work onto GPs e.g. Patients being discharged too soon postoperatively, patient being put on complicated medication(s) without being counselled adequately, rejected referrals by referral management agency ......

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  • Vinci Ho

    Interesting question:
    Does mass resignation mean all GP commissioners would also throw their towels and walk out in CCGs(which is something I have been suggesting)......?

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  • Vinci Ho

    Was watching Game of Thrones on Monday, some inspiring dialogue:
    Do you know what leadership means, Lord Snow?
    It means that the person in charge gets second-guessed by every clever little tw** with a mouth.
    But if he starts second-guessing himself , that is the end, for him, for the clever little tw**, for everyone.
    This is not the end, not for us, not if you lot do your duty for however long to beat them back....
    Ser Allister
    GOT S4 ep9

    Do not like to have your job ,Chaand........

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  • Like it or not mass resignation is not an option. Who is going to pay your staff? Who will foot the redundancy bills. Most of us are multi million pound businesses you don't get rid of your paymaster unless you have an alternative. Has anybody ever genuinely ever worked out how much they can make as a private service? I doubt many people have.
    Let's face it mass resignation is not an option & it never will be.

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  • NO OOH , 1 MONTH , JOB DONE .

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  • This comment by Chand demonstrates that the GPC has lost control. It is a response to the local negotiations taking place in Somerset Re abandoning the national Qof. If local negotiations are successful then it won't be long before other practices and LMCs look to do their own deals very much like what happened with the retired Qof indicators this year. This weakens the gpc position in national negotiations. The problem is practices are desperate and are prepared to go their own way as the gpc contact negotiations since 2005 have been incompetent. Practices may soon be in a situation of trying to provide services 2014 at present 2004 funding levels. An impossible task. My opinion is there should be a strong national contract and the fragmentation of the national contract is bad for primary care in the long term. But what do you do if you are caught between a rock and a hard stone?

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  • Crikey, what a victory? Reducing QOF by 40%?!?!
    By my estimates, we are left with just as much, if not more, bureaucracy with the re-routing of this funding into Unplanned Admission DES etc!
    Too much of the worried well, repeat attenders for trivial illness need to be weeded out, to give us time to manage those patients that need us and we can make a difference with!

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