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GPs ‘not ready to give up QOF’ in contract overhaul

Exclusive QOF is likely to remain in the new Welsh GMS contract in some form, the BMA’s GP Committee has said.

Speaking at a conference on the future of primary care, GPC Wales negotiator Dr Peter Horvath-Howard said there were no plans to abolish QOF at the moment but they would be looking to ‘minimise’ the framework and move more of the funding into the global sum.

It was revealed in May that the Welsh Government and GPC were starting negotiations that will see an overhaul of the GMS contract with the future of QOF a key issue on the table.

It comes as the Welsh Government temporarily suspended QOF earlier this year to relieve pressures on GPs, and agreement was reached for 2017/18 that some points would be ‘inactive’ and not related to payment.

But speaking with Pulse, Dr Horvath-Howard said: ‘I think there is a feeling we are not ready [to get rid of QOF] at the moment.

‘There is a reluctance on the basis of you have to be wary of what would come instead.’

But he added that they have had a ‘clear message’ from GPs that they want to reduce QOF.

‘The GPC Wales position at the moment is we are likely to retain an element of QOF and see how things go.

‘We have to consider there is a stability issue as well. In a way it is an acceptance that the profession is in trouble and we have to put some things on hold.’

Discussions on overhauling the GMS contract have just begun.

A stability agreement was reached for 2017/18 with a 2.7% uplift and new enhanced services for care homes, diabetes and warfarin management.

The GPC has said their focus for this year is on workload, workforce and resources.

Last man standing liabilities, indemnity, making greater use of pharmacists and other health professionals and improving cluster working will also be addressed as part of contract negotiations.

In her LMCs Conference speech in May, GPC Wales chair Dr Charlotte Jones said they would be delighted to see the commitment to resources seen in England and Scotland.

For this year’s Welsh GP contract, 40 points linked with depression COPD, heart failure, blood pressure, and cardiovascular disease were removed and transferred to the cluster network domain.

In guidance to GPs, the GPC said it reflected their ‘intention to reduce unnecessary bureaucracy and place greater reliance on cluster based peer review of clinical indicators deemed to be embedded in clinical practice domain’.

Is QOF coming or going?

In England, GP leaders were instructed by the LMCs Conference to negotiate to retain the QOF, marking a U-turn from the GPC’s previous policy.

The BMA’s Urgent Prescription for General Practice, published last year, called for the end of the QOF while returning all related investment into core GMS/PMS funding.

But at the LMCs Conference in May, LMC delegates voted in favour of a motion that said ‘disinvestment from QOF is no longer desirable’ and called for the GPC to agree a revised framework with indicators that are ‘evidence based’ and ‘clinically relevant’.

Earlier the same month, Pulse had revealed that GP leaders have met with NHS clinical chiefs to discuss altering QOF diabetes indicators next year, casting doubt on whether the QOF actually would be abolished in next year’s GP contract.

However, this all comes after NHS England chief executive Simon Stevens has said that the QOF has reached the ‘end of its useful life’, while the 2017/18 GP contract announcement included a stipulation that a working group would be set up ‘to discuss the future of the QOF’ after 2018.