GPs will have to work harder for QOF income as protected points reallocated

The refocusing of QOF so that practices concentrate on expanding flu vaccinations and catching up on cervical screening will see a doubling of points in these areas, with the points recycled from ‘income protected’ indicators.

The BMA said the ‘vast majority’ of QOF points remain protected, but GPs told Pulse they felt the change represented ‘extra work for the same money’.

According to an update from the BMA GP Committee, the points for flu vaccinations and cervical smear indicators will be doubled, from 29 to a total of 58.

Meanwhile points for other areas that practices will be expected to report on remain the same – at 74 for the delivery of modified Quality Improvement domain indicators on early cancer diagnosis and learning disabilities, 44 for prescribing indicators and 81 for disease registers.

However, the value of remaining indicators that practices will not have to actively report have been reduced from 339 to 310. The GPC said these would be paid based on historical activity – and urged practices to continue to deliver good quality care in these areas to demonstrate this is ‘not dependent on contractual requirements’.

NHS England announced last week that QOF would be refocused and restore certain elements, but did not provide details of how the work would be delivered and paid.

The GPC circular stated: ‘QOF guidance to support this approach will be produced very soon but in summary the points relating to influenza and cervical smear targets will be doubled to 58, the points for quality improvement (74), prescribing indicators (44) and disease registers (81) will remain the same and the other indicators (310) will have income protection.’

It added: ‘Income related to this element of QOF will be paid based on historic achievement. We are working on how that will be calculated. We would encourage practices to use their professional judgement in their management of patients with long term conditions, to do what they can within their capacity and capability over the coming months, and by doing so demonstrate that, even at times such as this, the delivery of good quality care is not dependent on contractual requirements.

Dr Simon Bradley, a GP partner in Bristol, said: ‘It was just plain stupid to reinstate QOF points for a date, 1 July, that had already passed. It instantly created a visceral response that these changes were going to be unfair. It confirms those suspicions of unfairness that the extra QOF points for flu and smears appear not to be extra at all, as the total number of points available appears unchanged. If this is true it represents extra work for the same money.’

Dr Dave Triska, a GP in Surrey, said: ‘It’s another weight to be carried by general practice – and feels like a kick in the teeth after the early pandemic efforts. I’ve lost faith with NHSE in the recovery phase… We will come out worse.’

A Norfolk GP, who wished to remain anonymous, added: ‘Relying on NHS England to work out the detail on income protection is laughable given the number of times they have moved the goalposts recently. Throughout this whole thing, practices have been treated unfairly – whether it’s the protection of staff with adequate PPE, or financial security for practices.’

A BMA spokesperson told Pulse: ‘NHSEI didn’t make a commitment to pause QOF for the whole of 2020/21.  This agreement will mean that the vast majority of QOF now does have income protection for the rest of the year, enabling practices to prioritise their work based on their local circumstances as the pandemic progresses.’

The news comes as NICE closed a consultation this week on new proposed QOF indicators for obesity, cancer and vaccinations, which will be subject to negotiations between the BMA and NHS England.