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GPs to see QOF part-suspended until April to free up time for Covid vaccinations


QOF


Parts of QOF will be suspended and income-protected until April to free up GP capacity for delivery of the expanded Covid booster programme, NHS England has announced.

However, QOF indicators covering vaccination, cervical screening, register indicators and those related to optimal prescribing will continue to be paid on the basis of practice performance, it said.

NHS England also said that while PCN incentives around flu immunisation and appointment recording will be paid as normal, the remaining indicators in the network incentive scheme will be ‘suspended and funding repurposed’ until April.

In a letter sent to GPs today, NHS England also set out a range of other measures to create ‘capacity’ in primary care:

  • Income protection for the Minor Surgery DES from 1 December until 31 March 2022 for practices participating in the vaccination programme, with monthly payments to be made matching the corresponding period in Dec 2018 to March 2019. No contract enforcement where ‘no activity is done’ under the Minor Surgery Additional Service during the same period, but any capacity released ‘must be redeployed to vaccination’
  • Routine health checks for over-75s and new patients may be ‘deferred’ from 1 December until 31 March ‘where contractors consider it clinically appropriate’
  • An amendment to the Dispensing Services Quality Scheme reducing the requirement for medication reviews from a minimum of 10% of dispensing patients to 7.5% for 2021/22 – with practices asked to ‘prioritise’ patients considered ‘higher-risk’ or most likely to benefit from a review
  • The CQC has ‘confirmed that routine inspections of practices will continue to be paused’ and only risk-based assessments undertaken, where ‘deemed critical to safety and quality’

The letter said: ‘The evidence-based care provided via QOF continues to be important in minimising health inequalities, securing the best outcomes for those with long-term conditions and preventing wider system impacts.’

But some changes will be introduced for 2021/22 ‘in order to support the ongoing response to Covid-19 and the increase in vaccination capacity, combined with the need to target proactively and support our most vulnerable patients during this period’, it added.

It said: ‘Some QOF indicators will continue to be paid on the basis of practice performance. These include vaccination, cervical screening, register indicators and those related to optimal prescribing.

‘Others will be subject to income protection based upon historical practice performance, in a similar way to arrangements in 2020/21.’

It added: ‘To be eligible for income protection, practices will need to agree with their commissioner a plan that will set out how QOF care will be delivered wherever possible but with priority according to clinical risk, and accounting for inequalities.’ 

Normal QOF arrangements will ‘recommence in April 2022’, it said.

NHS England also set out a part suspension of the PCN investment and impact fund (IIF), which will also restart in April.

Indicators introduced in April 2021 covering flu immunisation and the ‘completed work on appointment recording and categorisation will be paid as normal’, while the remaining indicators will be ‘suspended and the funding repurposed’, it said.

It added: ‘The majority of the funding allocated to these suspended indicators will instead be allocated to PCNs via a PCN Support Payment, on a weighted patient basis, subject to confirmation from the PCN that it will be reinvested into services or workforce. 

‘The remaining funding will instead be allocated to a new IIF incentive to support PCNs whose practices are fully participating in the vaccination programme. Further details will follow.’

The letter said the measures have been put in place ‘given the invaluable contribution and scale of effort required in primary care’ and will ‘allow wherever possible practices and PCNs to continue to pursue the clinical ambitions underlying QOF and IIF while releasing capacity to support the increased vaccine effort’. 

It added: ‘We recognise the pressure all local services are under, however as the Secretary of State for Health and Social Care has said, the “new national mission” is to increase vaccine capacity. 

‘There are no supply challenges with either the Moderna or Pfizer booster stocks, therefore all vaccination sites are now asked to load their NBS calendars to the end of January, where possible.’

Meanwhile, the letter also expanded on the increased ‘financial support’ in the form of raised vaccination fees announced earlier this week to help ‘sites attract and retain staff, including during unsociable parts of the week’. 

PCN vaccination sites can claim:

  • An item of service (IoS) fee of £15 per jab administered Monday-Saturday from 1 December to 31 January (excluding bank holidays)
  • A £20 IoS fee per jab given on Sundays or bank holidays over the same period
  • A £30 supplement for third doses and booster jabs for housebound patients until 31 December, backdated for those already carried out
  • A temporary £10 supplement Covid jabs administered to severely immunosuppressed people from 1 December to 31 January
  • An ‘enhanced payment’ to support clinical director and management leadership of PCN sites to 1 WTE for the period 1 December to the end of March 2022

NHS England has reopened sign-ups for the phase three GP Covid vaccination enhanced service and any practices wishing to join the programme should ‘liaise with their local commissioner as soon as possible to discuss next steps’, it said.

And there is ‘some opportunity’ for PCN-led sites to be onboarded to the national booking system (NBS) where there is a ‘strategic need’, although onboarded sites should use the system for the ‘majority’ of their bookings’, it added.

The NBS, Patient Group Directive (PGD), National Protocol and Green Book are being updated to reflect the shortened three-month interval between second doses and boosters ‘as soon as possible and no later than 13 December’, but existing booking arrangements remain in place in the meantime, NHS England said.

It confirmed that ‘no immediate action is required’ regarding new JCVI advice on second Covid vaccine doses for 12-15s but said it would ‘write separately on implementation of this advice’.

The BMA welcomed the support measures, saying that they ‘begin to recognise’ that GPs ‘cannot do everything for everyone all of the time’ due to the ‘finite number’ of staff and hours in the day.

BMA GP Committee England chair Dr Farah Jameel said: ‘We hope that, by removing some of the more bureaucratic and target-based requirements within practices’ contracts, staff time can be freed up to get more jabs into arms, while allowing practices to focus on patients who need their attention the most.

‘Patients need to know that if they are unwell or have concerning symptoms and need to receive care from their practice they will continue to be prioritised and GP teams will continue doing their very best to keep their sickest patients safe in every way they can and know how.’

It comes as the health secretary this week said that the Government was working to ‘free up’ GP time so they can dedicate themselves to delivering Covid booster jabs.

Earlier this week, GP leaders called for GPs to be freed up to focus on speeding up the Covid booster jab campaign in response to the new Omicron variant of concern – including by suspending QOF.

And England GPs last week called for NHS England to ‘guarantee funding security’ for GP practices until the end of March.

The Prime minister has announced a target for the NHS to offer booster Covid jabs to all over-18s within two months.

Meanwhile, the Government announced yesterday that it has secured 114 million additional Covid vaccine doses for next year and 2023.

READERS' COMMENTS [10]

Dr N 3 December, 2021 3:52 pm

Editor – the ‘letter’ link is wrong

Reply moderated
C B 3 December, 2021 5:05 pm

How long does it take to update the green book to say 3 months instead of six? So now they have ramped up demand and are making us all wait to book then in until the 13th which means everyone will want their booster over christmas, do they really have a plan to just annoy us on purpose?

Reply moderated
Patrufini Duffy 3 December, 2021 5:19 pm

Mostly trivial conjured activity anyway – this is not ground-breaking in the slightest – and shouldn’t be seen as that considering how you have been treated. But, the excel data sheet lovers will be sad – watch the media blow this out of proportion. Lazy GPs not doing work, on top of not doing any work.

Reply moderated
The Prime Minister 3 December, 2021 5:30 pm

KEY PEOPLE WILL BE ON THE PHONE TO THEIR “SECRET FRIENDS”….NOBODY KNOWS ABOUT…EXCEPT THE WHOLE BLOODY GOVERNMENT……THE DAILY NUTTER WILL BE RUNNING ENDLESS CRIMINAL STORIES ABOUT GPs…..I FIRMLY BELIEVE THAT ONE DAY THE TRUTH WILL OUT AND THOSE JOURNALISTS SECRETLY WORKING FOR POWERFUL PEOPLE SLAGGING OFF GPs WILL BE CHARGED AND JAILED FOR THEIR CRIMES. ….

Reply moderated
David Jenner 3 December, 2021 7:21 pm

Sorry guys and gals , I think this is a very genuine offer to practices to reduce workload to enable us all to help solve a national emergency.
Some of the words are designed to keep the Daily Mail at bay from government not us.
For the vocational this is a just cause .
For the overworked there is a chance to re profile workload to do this.
For the atavistic there is a profit line in this .
And for patients there is a huge benefit in getting a local jab from someone they trust and know near to their homes .
It’s a shame this was not offered immediately but we should now ( in my opinion ) sign up and do this !
Who would not rather do this than tick boxes for the QOF and IIF ( now mostly decontaminated )

Reply moderated
Douglas Callow 3 December, 2021 8:48 pm

David Jenner-neatly put and spot on

Reply moderated
C P 3 December, 2021 11:05 pm

Nope this is utter trivia.
This will reduce workload by nothing as no one has time to do this stuff normally.

Reply moderated
Slobber Dog 4 December, 2021 11:53 am

Nothing to see here, move along.

Not on your nelly 4 December, 2021 2:12 pm

‘Some QOF indicators will continue to be paid on the basis of practice performance. These include vaccination, cervical screening, register indicators and those related to optimal prescribing.’

Pulse, could you let us know which parts we don’t have to do? Isn’t that almost all of QOF?

Jonathan Heatley 5 December, 2021 10:32 am

this is good news and helpful. Its been refreshing to have less tick box activities and wonderful not to have the demoralising CQC picking holes in us while we struggle to keep going.