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QOF activity could become unprofitable, accountants warn

Accountants have warned that reforms to the QOF indicators mean GPs might have to pick and choose activity to stay profitable.

The BMA revealed last week that practices will face a £31,000 gap in QOF funding next year unless they work much harder under the proposed contract deal.

Bob Senior, head of medical services at accountancy firm RSM Tenon, told Pulse removing points from the organisational to the clinical domain would hit practices hard.

‘Increasing the thresholds will undoubtedly make the business case for carrying out some work difficult to justify,’ he said.

Dr Gavin Jamie, a GP in Swindon who runs the QOF Database website, agreed that some of the ‘observing indicators’ such as checking weight in diabetes and smoking status would not be worth it.

He said: ‘The payment per patient is in pennies. It’ll become the case that if it’s in front of you it might be worth doing, but not much more than that.’

Dr Una Duffy, chair of Bedfordshire and Hertfordshire LMC, said her practice was already looking at what activity it could stop before April, and urged the GPC to take action.

She said: ‘GPs are between a rock and a hard place trying to save money but offer services to patients. We need to draw a line in the sand somewhere and we don’t seem to be doing that. Nothing happens and we’re faced with more of the same changes – we need to act.’

This comes after the GPC tempered calls for a possible boycott of commissioning from LMC leaders. 

GPC chair Dr Laurence Buckman told a behind-closed-doors LMC Secretaries’ Conference last week that so many GPs are already committed to CCGs that a boycott ‘wouldn’t work’.

The GPC is awaiting final details of the formal consultation on the GP contract changes for 2013/14 from the Department of Health before deciding what course of action to take.

Readers' comments (6)

  • David Bush

    This is a ridiculous situation, where we have to pick and choose which bits of QOF to do. If something is optional then it should not be in QOF. Everything within QOF should have tangible benefits to the health of the patient, and we should therefore feel morally obliged to deal with them. If it has no benefit then chuck it out of QOF. But you must recompense us realistically for the areas of real benefit.
    The architects of QOF must be held to account for those areas they have pushed in which should not be in there. We need better representation from grassroots GP's when changes to the QOF are planned.

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  • QoF was always supposed to be optional, but because of the pay freeze, practices have become financially dependent on it. Our practice will certainly stop any QoF work we presently do if the funding is withdrawn. The DoH seems to think that providing financial incentives for a few years means that practices will simply continue the work when funding is moved elsewhere - do they think we're daft?

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  • Yes, we are daft. QOF is pennies. Consultation is £4.00 each. Please do the maths. Who wants to stay in the NHS ? We are being targeted , discriminated against and bullied. We have to resign.

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  • silver surfer

    The QOF changes are not about chucking bits out and keeping bits in.There will a fundamental change if we move from percentages achieved to quartiles many groupings will require over time a requirement to hit 100% or should i say 99.99%.This will in essence render most top targets unachievable! I do hope the troops on the ground understand this.

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  • Peter Swinyard

    I won't say i told you so, but I did - see my comments in Pulse's "Big interview" last week (available if you search at top of screen on "Big Interview".

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  • Mark Struthers

    Sadly, many GPs have sold their souls and their professionalism … to the “stupid, paper shuffling nonsense” that is the QOF. *

    * Des Spence, From the Frontline: Save our souls, BMJ April 2009
    http://www.bmj.com/content/338/bmj.b1420.full

    Go figure, Una Duffy!

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