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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.