The GPC will push for the QOF to remain unchanged in this year’s contract negotiations, while also trying to safeguard GPs from a further surge in workload, GPC chair Dr Laurence Buckman has told Pulse.
In an exclusive interview, Dr Buckman said the GPC would push to convince the Government that GPs require stability to the contract during an intense period of change.
It comes after LMC leaders at their conference in May unanimously backed a motion demanding ‘no changes’ are made to the QOF for the next two years ‘in order to accommodate the changes to commissioning’.
Dr Buckman said that while there was likely to be some inevitable changes to the QOF based on updated NICE evidence, negotiators would fight for the framework – which represents around 20% of GP practice funding – to remain as untouched as possible in the 2013/14 contract.
He said: ‘We always try to minimise the changes to QOF every year. It is in nobody’s interest to keep on having changes. The only change we would willingly accept is if the NICE evidence changes. Although we don’t accept all the NICE changes either, we do try to observe evidence base. How will the QOF change? Ideally, not at all, but in reality there will be some changes. We will try to keep them as minimal as possible.’
It comes as NICE is already working to develop a number of QOF changes to be instated as part of the 2013/14 contract subject to GPC and NHS Employers approval. These include proposals to introduce a new extended biopsychosocial assessment tool for depression, which has received some criticism for being too time consuming and taking a ‘box-ticking’ approach to the relationship between GPs and vulnerable patients.
Other indicators pending inclusion to the QOF include new guidance on COPD and cardiac rehabilitation, the number of patients with diabetes asked if they suffered erectile dysfunction, management of cholesterol in patients with diabetes and timely reviews of depressed patients, as well as new recommendations on blood pressure, arthritis, asthma and cancer.
Dr Margaret McCartney, a GP in Glasgow, said the GP contract ‘is not used well enough.’
‘There should be less contract and more professionalism,’ she said. ‘The contract has become all guidelines and protocols. It has gone too far and is not making patient care any better. My life now seems to be about filling out PHQ9 depression indicator forms, when there is no evidence they actually work.’
Dr Buckman added that a key target in this year’s negotiations would be to ensure that GPs’ workload is not increased further without any new funding for practices to cope with the additional pressures.
‘There has been a steep rise in workload, and I think everybody would just like to work less hard,’ he said. ‘Indeed, if you ask people which they prefer, they would rather have less work and leave the pay alone rather than more work and more pay. I certainly don’t think I could work any harder and I hear that from others all the time.
‘The main thing to do will be to try and keep our contract stable and ensure our income doesn’t fall any further.’
Earlier this week, Pulse revealed that the Scottish Government has tasked Health Improvement Scotland with preparing QOF indicators specific to Scotland that could come into effect by 2014.