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GPs struggle on QOF quality and productivity prescribing indicators

Exclusive: GPs have missed out on practice funding worth up to £2,000 under the new 'quality and productivity' domain of the QOF, with more than a quarter of practices failing to gain the maximum points available under prescribing indicators introduced last year.

Figures obtained by Pulse from 31 primary care organisations reveal just 72% of practices achieved maximum points against one of the prescribing indicators.

The data, released under the Freedom of Information Act, shows GPs performed well on reviewing and implementing plans for reducing outpatient referrals and emergency admissions, with 97% of practices achieving maximum points for the full set of indicators.

The initial performance of GPs on reviewing their prescribing and agreeing a plan of action with NHS managers was
also impressive, with 98% of practices achieving maximum points.

But performance fell when it came to implementing the plans, with only 75%, 72% and 77% achieving maximum points for the three areas agreed.

Combined, the three indicators are worth £1,958 for the average practice.

Figures from NHS Trafford showed no practices gained maximum QOF points for looking at their prescribing of ezetimibe and statins, and only a quarter did so for PPIs.

In NHS Somerset, only 37% of practices achieved maximum QOF points for improving their first area of prescribing, with areas such as statin and alendronate prescribing proving particularly difficult.

Dr Barry Moyse, deputy medical director of Somerset LMC, said practices had struggled to convince patients to switch to cheaper alternatives: ‘[Patients] try them for one or two prescriptions and then come in and change. This causes more waste, which isn't factored in. We should respect patient choice and shouldn't see them as prescribing units.'

GPC member Dr Helena McKeown said her practice in Salisbury struggled as it tried to make gains following years of prescribing efficiency savings: ‘There's a real worry it's undermining patient- doctor trust. '

The 11 ‘quality and productivity' indicators were brought in under the 2011/12 GMS contract, by retiring indicators and reassigning nearly 100 points.

Dr Peter Holden, GPC negotiator, said GPs faced ‘target fatigue': ‘We were aware of these problems, but the Government wanted them in.

‘We agreed to them because they were the least worst options.'

A DH spokesperson said the figures represented only a ‘snapshot of local achievement', and full data would be published in October.