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Hike in QOF thresholds planned over two years



GP practices will have to work much harder for their QOF funding under Department of Health proposals to dramatically raise indicator thresholds.

The DH said it wanted to raise the upper thresholds for QOF indicators over a two-year period so that they are in line with the upper quartile of current performance.

It also said that this link would be maintained ‘in setting future thresholds’.

The DH said the move would ensure that more patients benefited from ‘best practice in areas such as keeping blood pressure low and reducing cholesterol levels’ and that it wanted to target those who were ‘hardest to reach’.

But the GPC warned the move would threaten individualised treatment for patients and could jeopardise patient care.

In a letter sent to PCTs and SHAs today, the DH said that the move was supported by research showing higher thresholds would save more lives.

The letter said: ‘The department proposes to raise the upper thresholds for QOF indicators so as to promote improvements in the numbers of patients who benefit from the evidence-based care reflected in the QOF.’

 ‘At present, these upper thresholds are below average achievement levels. Independent research has shown that, when the QOF was first introduced in 2004, it is likely that it reduced mortality by 11 lives per 100,000 people, but that providing the same interventions for all relevant patients could save 56 lives per 100,000 people each year.’

‘The department proposes to raise upper thresholds over a two-year period so that they are in line with the upper quartile of current performance and maintain that link in setting future thresholds.’

But GPC negotiator Dr Chaand Nagpaul said raising thresholds would risk patient care.

‘We are very concerned about the counter-productive effects of raising thresholds too high and the risks to patient care,’ he said.

‘There are reasons why QOF is designed to have thresholds at a certain percentage. It protects the patients from GPs simply trying to treat all patients the same, and recognises the fact that there needs to be some variability in the way we manage patients.’