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A faulty production line

QOF has reached the end of its useful life, says NHS chief

QOF has reached the end of its useful life, according to NHS chief executive Simon Stevens, who said that new GP contracts will phase it out.

Speaking at the Best Practice conference in Birmingham today, Mr Stevens said QOF had ‘delivered the gains it is going to produce’ and had now descended into box-ticking.

He suggested that new models will be trialled by GP organisations who are caring for patient populations of 30,000 plus and take on the new voluntary GP contract.

Mr Stevens said NHS England is currently working with a number of GPs 'on what an additional voluntary GP contract option would look like' adding: 'But a lot of people are saying this is a way of stepping out of and beyond QOF.

'My view is that QOF is now nearing the end of its useful life, it has produced those gains it is going to produce, and for the most part it has descended into too much of a box ticking exercise.'

But he stressed he does not envisage general practice going ‘cold turkey’ on QOF.

He said: 'We have to be thoughtful about how we do that, we can’t just go cold turkey on QOF from 1 April, but in the next 18 months we can use people like the members of the NAPC, to get it right.'

A model for the voluntary contract is due this autumn with the first versions set to roll out in April 2017.

Mr Stevens ended with his assessment of the state of general practice, quoting the Charles Dickens novel A Tale of Two Cities.

He said it was 'the worst of times, in the sense that the pressures have never been greater', but also the 'best of times, in that I do genuinely believe we are moving from denial, through the acknowledgement stage, through to the action stage nationally.’

In the same speech, Mr Stevens also announced that 300 practices are due to be handed funding from NHS England's premises and IT fund, and that 30 CCGs will receive funding to offer psychological therapy in GP practices to patients with long-term conditions.

GPC chair Dr Chaand Nagpaul said: 'We agree that QOF has reached the end of its useful lifespan, and it is good that Simon Stevens agrees with the BMA’s GPs committee as we have already called for the end of QOF in our Urgent Prescription for General Practice.

'This bold step, long overdue, will have a positive effect on practices by reducing bureaucracy and box-ticking, and allowing GPs to focus on the complex care needs of their patients.'

But he added that it was 'important that the phased removal and end of QOF should apply equally to all practices, regardless of their contractual status, and must not be used as a lever for movement away from the current contract to a voluntary local contract'.

He said: 'We believe that patients’ needs are best served under a national GP contract that provides nationally specified consistent standards of care.'

What is the new voluntary contract?

NHS England has said there will be three levels of sign-up to the 10-15-year contracts, which will allow practices to hold on to their GMS contracts alongside the new contract if they so wish, but will also give the option of becoming fully integrated into a 'multispecialty community provider' - which will provide secondary care services as well.

There will also be a watered down contract for practices working in an alliance to provide certain services.

NHS England has said the fully integrated model will include a 'gain/risk share' for acute activity, meaning that funding for the organisations will depend on reducing acute admissions.

The contract will also include a capitation element based on the size of its patient list, and a performance element to replace QOF - as already announced by then Prime Minister David Cameron - and the secondary care equivalent, CQUIN.

The GPC has warned that there were risks to practices signing a local time-limited contract.

Readers' comments (29)

  • NHSE, RCGP, CQC have long since reached the end of their useful lives also

    comrades if you dont yet realise who the mugs are.....its probably you

    ditch the country comrades!!!!

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  • Seems a shame to switch off the annual reviews and register based approaches that QOF has brought, they have had real benefits.

    Probably fair though that those are now the norm for most, sadly not all, practices.

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  • The end of QOF?
    Beware that it doesnt just mean that the income from QOF gets sliced off the income of hard-working practices... to fill the black hole of financial deficit.
    Whatever next? .. they will come for your Enhanced Service income.

    Then there will be no viability left in General Practice .. end of!

    Dont hold out any hope in the new model voluntary contract, there will be none there.

    Resources for General Practice to take part in Community Care projects in STPs? .. dont hold your breath

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  • It's not only end of QOF,it's the end of general practice! Alan Milburn's New GMS contract started it, Lansley's reforms Brought to the cliff , Simon Steven's STPs will push it! Thanks to BMA,RCGP.......General practice 'Jewel in the crown' is just reduced to ashes.....

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  • NHS Chief has reached the end of his useful life, says QOF.

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  • practices appointed extra staff to get qof points and money. if money goes then what happens to staff?. they just can't stop doing things to destablise practice finance. there is a bad news for practice finance every week. mpig goes, senority payment goes, pms practices deprived of funding, enhance serviced for tender. no wonder no one want to be gp partner any more.

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  • Hmm...history tells us that the work is likely to remain but the funding transferred to other work. In this way NHSE just keeps extracting more and more from practices. Don't expect the funding to be just transferred into the basic GMS contract.

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  • Should any reader wish to know the detail of this speech and the context in which it was made at the NAPC annual conference today, please contact
    Dr J P Kingsland
    President NAPC

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  • And you know what Simon?:
    It is a far far better rest I go to than I have ever known.

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  • Russell Thorpe

    One man and his dog, the sheep are in the pen and he pulls on the rope to swing the gate shut.

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