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NHS England backs QOF suspension as an ‘innovative’ way of commissioning GPs

Exclusive NHS England has backed its local area teams in allowing some GP practices to ditch the QOF for the rest of this financial year, saying that it was an example of an ‘innovative solution to commissioning primary care’.

The body said it supported a radical agreement between NHS Somerset CCG and the local area team to ‘switch off’ QOF reporting and pay practices for their estimated achievement for the rest of the financial year.

NHS England said that it was important to encourage local collaboration to ‘deliver high quality services’ and it supported moves to ask GPs to provide new services and making a ‘payment to compensate for loss of QOF income’ as a result.

It also backed a move by area team officials in Devon and Cornwall to suspend work on QOF work that would be removed from the framework in April to focus on other priorities, although it said that it was not a ‘blueprint’ that it was recommending other local area teams to follow and that it would not be suspending the QOF nationally.

The plans to suspend QOF reporting in Somerset from January, and still pay practices what they would have earned under the framework, is designed to encourage practices to participate in a CCG-wide project to ‘redesign GP services’ before April 2014.

But it has caused consternation at the GPC, with deputy chair Dr Richard Vautrey saying that breaking away from the national contract in this way could leave practices adrift if they come against problems.

A spokesperson said: ‘NHS England is committed to working collaboratively with CCGs to support general practice deliver high quality services aligned to the local priorities.

‘As the contract holder for primary care, it remains our position that NHS England should not simply “suspend” on a national basis the QOF indicators that are scheduled to be retired ahead of April 2014. That would require changes to secondary legislation which could not be introduced before the end of the financial year.

‘[But] an area team could, however, reach agreement with its practices that, in recognition of some other services that they have agreed to provide, the area team will make a payment to compensate for loss of QOF income that may have arisen from providing that other service, but this is different from suspending QOF requirements altogether.’

But Dr Beth McCarron Nash, GPC negotiator and a GP in Cornwall, who was part of Cornwall LMC’s negotiations to bring forward QOF changes in that area, said the changes in Somerset were ‘concerning’.

Dr McCarron-Nash told Pulse: ‘Area teams do not have any mandate to negotiate local contracts – they are outposts of NHS England and in legislation they have no jurisdiction.

‘They can – with agreement of NHS England – look at local arrangements, but in terms of deviating from a national agreement they do not have any mandate to do that.’

Dr McCarron-Nash added: ‘I think practices need to be very careful that they don’t end up being offered very stringent [key performance indicators] that actually make them end up with a worse deal.

‘We haven’t seen the detail yet – but certainly I have expressed concerns about practices who whole-scale give up the QOF. Although we’re fed up with the box-ticking, and the monster the QOF had become, what we don’t want is end up with an even bigger monster.’