Northern Irish GPs push QOF renegotiation onto national agenda

Northern Irish GPs have pushed a renegotiation of the QOF onto the national agenda after voting through a motion to ask the Department of Health to negotiate a new solution with the GPC.

GPs in Northern Ireland took the decision at their annual LMC conference on Sunday (14 April) and will now call ‘upon the Departments of Health to negotiate with GPC to achieve a revision, based on simplicity, clarity and evidence’.

The UK GPC said the point is likely to also be discussed at the national LMC Conference next month, although the final agenda for the conference has yet to be set.

It comes as Pulse reported last week that the motion would be backed by the Northern Irish GPC, with its chair Dr Tom Black telling Pulse that QOF has become ‘complex and difficult’

The conference also saw Northern Irish GPs voting in favour of opting back into out-of-hours care, and rejecting any calls for NHS 111 to be rolled out in Northern Ireland as a solution for out-of-hours phone triage after the questionable English rollout.

Explaining the move, Dr Black said GPs are deeply concerned with the lack of investment in OOH in Northern Ireland, which has fallen from £25 million to £19 million over the last 10 years, and that they therefore want to take control of commissioning and delivery before the quality of care is eroded.

Mirroring Scotland’s LMC conference last month, Northern Irish GPs also decided that ‘now is not the time’ for an Northern Irish GP contract and that four-nation negotiations still have ‘considerable advantages’.

A number of motions were not voted on, including a no-confidence vote over DHSSPS (the Northern Irish health department) among other contract-related motions. This came after Northern Irish GPs clinched a last-minute contract deal at the end of last month that NI GPs found to be acceptable.

Dr Black commented: ‘There was real feeling that QOF is scraping the bottom of the barrel with regards to new evidenced-based work and that just because NICE said that something was evidenced based didn’t mean that it should be included in QOF as the real world and target based activity could disrupt patient-centred care.’

With regards to out of hours, he added: ‘GPs are concerned that out OOH will fall off a cliff in the next 18 months in Northern Ireland as patient complaints increase and GP confidence in the present arrangements erodes. We are concerned that if GPs begin to think that OOH underfunding has made the service unsafe then they will leave as one. GPs at LMC conference have determined that if Humpty Dumpty is going to fall off the wall then we should really try to help now rather than wait until after the fall when it can’t be put back together again’.

‘So GPs will form federations as part of the commissioning structures and will look to take control of commissioning and delivery of OOH. We will then need to ensure that OOH provider organisations are GP-led or mutual organisations.’