Exclusive GPs from the same CCG could be working towards separate local incentives schemes, under plans being drawn up by clinical commissioners.
NHS Greater Preston CCG and NHS Chorley and South Ribble CCG are working on a replacement for the QOF which will see it being localised to a greater extent than ever, with separate indicators based on practices’ locations.
The scheme, being introduced under co-commissioning, has not yet been finalised but is likely to feature indicators relating to referral rates, prescription rates, and admission rates alongside conditions such as heart failure, diabetes and respiratory illnesses.
Jan Ledward, accountable officer for both CCGs, said that aspects of the national QOF and enhanced services have been too prescriptive and so the region needs to introduce different incentives.
Ms Ledward said: ‘We want to change our enhanced schemes and bring in a new QOF for primary care. It won’t be a tick-box exercise.’
The CCGs are involved with ‘talks ongoing with GPs’ about introducing the incentives scheme, she said.
She added: ‘The incentive schemes used in the past have been too prescriptive, but we want to introduce systems that meet the needs of the practice populations.
‘In some parts of our region we have very few people over 75, and large numbers of young people who are studying at the University of Central Lancashire. So we need different outcome measures to reflect different populations.’
She said: ‘We will be commissioning for outcomes, which is very new.’ The measures will relate to ‘patient experience, quality of life and value for money of the services’.
Pulse has reported that CCGs are already bringing in QOF replacement schemes having taken on co-commissioning responsibilities.
GPs in NHS Aylesbury Vale CCG are already being given the chance to drop the unplanned admissions DES and instead receive payment for advance care planning and end-of-life care for 0.5% of their patient lists.