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Local scheme to replace the QOF ‘a success’

GP leaders involved in a local quality scheme held up by NHS managers as a potential replacement for QOF across the country have said that the scheme has maintained high quality of patient care while ditching reporting.

LMC leaders said the Somerset Practice Quality Scheme (SPQS), run by NHS Somerset CCG, looked likely to continue after ‘reassuring’ provisional findings from an independent evaluation of the scheme and the impact on general practice.

The final evaluation has been widely anticipated after NHS England told CCGs that they could ditch QOF as part of co-commissioning, based on the Somerset model, which allowed practices to drop reporting in all but a small set of core clinical QOF indicators when introduced last year.

Pulse revealed that a number of other CCGs were planning to ditch QOF as a result.

Commissioning leaders heading up NHS England’s co-commissioning drive indicated that CCGs would likely wait until a review of the success of the Somerset model are published, which is due for July this year, although some CCGs said they would be looking to start local incentives schemes earlier than this.

The LMC says that initial findings of the evaluation by the South West Academic Health Science Network suggest the scheme has been a success, and that the ‘key concern of stakeholders’ – that the quality of clinical care may decline – has not come to pass.

Somerset LMC minutes state: ‘We are now at the stage of the year where those who are signed up are viewed with envy by those who have not and are dealing with the QOF lists coming through with a vengeance.

‘There seems to be a growing national view that the value of QOF as it stands is in doubt and we anticipate SPQS will continue at least in to 2015/16. Early indications show that already we can demonstrate that quality of general practices in managing conditions in areas that really matter to patients has not been sacrificed by the implementation of the SPQS.’

The Somerset scheme got off to a delayed start last June, with 55 out of the 75 GP practices in the area eventually joining the scheme.

Participating practices have dropped reporting of all but a small set of ‘core clinical’ QOF indicators in place of delivering regular reports to the area team on how the released funding has been used to improve local services in three key areas, namely integration of general practice with urgent care service, improved personalised care and building practice sustainability.

NHS England advisers held up the scheme as an example that other CCGs can follow when taking on co-commissioning responsibilities.

Dr Amanda Doyle, co-chair of NHS Clinical Commissioners and NHS England’s adviser on the Next steps towards primary care co-commissioning guidance document, told Pulse last year that CCGs should ‘evaluate the Somerset pilot and roll out any learning from that’ before implementing their own QOF schemes.

Dr Harry Yoxall, medical director at Somerset LMC, told Pulse early signs indicated that the quality of care had not suffered as a result of dropping QOF.

He said: ‘The Academic Health Science Network for the South-West, which is looking into ensuring that quality of care has not been impaired by SPQS, has produced some very early tentative suggestions that the quality of care has been maintained.   

‘It hasn’t been running long enough to state anything categorical, but we were reassured that the quality of care taken as a whole hadn’t collapsed in the SPQS practices.’

 Dr Yoxall added: ‘The area team, the CCG, and the LMC have been reassured that there is still interest among practices, and that the information we have suggest it is worth continuing with the experiment.’

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