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Fears for QOF funding as NHS draws up contingency plans to pay GPs from next month



Exclusive NHS bosses have been forced to draw up emergency plans to ensure GP practices will be paid for QOF work from next month, with a final decision on whether to deploy the new system designed to calculate practices’ achievement not due to be taken until the end of March, Pulse can reveal.

‘Contingency options’ have been drawn up by NHS England and the Health and Social Care Information Centre (HSCIC) in order to pay practices for their estimated QOF performance in 2014/15 from April if it is not possible to do so through the new Calculating Quality Reporting Service (CQRS) system.

Managers are also discussing ‘a number of options’ to ensure that QOF achievement payments for 2013/14 are paid from June in the event that practice QOF data is not available via the General Practice Extraction Service.

But GP leaders have warned that any contingency plan must not pile additional workload on practices or delay payments, amid fears that QOF funding could be disrupted.

Minutes from the HSCIC published in February reveal there have been ‘some technical issues’ with the implementation of the GP Extraction Service, which is ‘on the critical path for QOF and care.data extracts’, but say that the situation is ‘improving’ and ‘mitigation’ is in place.

The GPES and CQRS systems were supposed to save GP practices time by automating the recording and approval of DES, QOF and vaccination payments. But GPES and CQRS have been plagued with technical problems, with GPs forced to take on the time-consuming task of manually inputting data and hundreds of practices facing frustration when their passwords to the reporting system expired without warning.

HSCIC has repeatedly assured practices that the technical problems would be remedied in time for the end-of-year QOF extractions next month, but in its latest statement revealed that contingency plans are being put in place, with practices only due to be informed at the end of March if they will be implemented to ensure practices are paid for the QOF.

An HSCIC spokesperson was unable to say what the contingency plans were, or what additional work they could involve for GPs, but said that they would mitgate any ‘unforeseen issues’ with the new system.

She said: ‘Protecting achievement and aspiration payments is our main priority in the event that QOF data is not available via GPES for all GP practices by the end of March.’

‘With this in mind, NHS England and HSCIC have developed a contingency option that will ensure an estimated QOF 2014/15 aspiration payment will be made to GP practices through CQRS in April as normal.’

‘For QOF 2013/14 achievement, a number of options are being discussed to ensure the payments are made within expected business timelines. More information will be available shortly on how this will be achieved.’

She added: ‘It is normal when implementing a new system to plan contingency options in case of unforseen issues; however the contingency plan has not been invoked as yet. HSCIC will determine at the end of March if the contingency will be implemented to ensure that GP practices receive their QOF 2014/15 aspiration payment in April.’

But Dr Grant Ingrams, a GP in Coventry and former chair of the GPC IT subcommittee, warned the uncertainty was causing alarm among GPs, with QOF accounting for a significant proportion of practice income and other payment issues resulting from the handover to NHS England from PCTs still not fully resolved.

He told Pulse: ‘They’ve had several years to sort this out, and it’s a bit of a mess that with a few weeks to go we’re still waiting to hear definitively whether CQRS is going to work or not.’

‘I would hope that any contingency plan did not require any unresourced work on the part of practices, and would not result in any delay in payment causing further financial hardship to practices that are already having huge problems with financial cash flow.’

Dr Gavin Jamie, a GP in Swindon who runs the QOF database website, said GPs needed more clarity on what the contingencies might involve.

He said: ‘I doubt any contingency plan is going to be any easier than the CQRS plan – it’s almost certainly more work. It’s going to be more people-intensive to do.’