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Practices could face £2,000 drop in this year’s QOF income



Exclusive The value of the QOF work GPs are currently doing has not yet been decided, leading to fears that practices will lose out on payments worth up to £2,000 even if their achievement remains constant.

Pulse has learnt that the GPC has not negotiated an uplift to the QOF point for 2014/15 yet, which would be essential for practices to maintain their earnings due to increases in the average list size – which is used to ultimately calculate a practice’s payments.

NHS England committed to increasing the value of QOF points last year, but has refused to provide a similar commitment during contract negotiations this year, insisting on separate negotiations that are ongoing.

If GPC is unable to negotiate an further increase in the value of the QOF point this year, the average practice could lose out on around £2,000 for the QOF work they are doing this year.

The imposed GP contract in 2013/14 introduced a committment that QOF payments should be adjusted annually to reflect the actual average list size of GP practices.

At the time it said that the change would be ‘cost neutral’ because it was also increasing the value of the QOF point by the same proportion, reflecting the fact that a larger practice would be able to achieve more.

But Pulse revealed this week that the Health and Social Care Information Centre was mistakenly using the 2014 list size average for 2013/14 QOF payment calculations – when it should have been using the 2013 value – leading to GPs being told the wrong estimates of their QOF performance.

And in an even more serious twist, Pulse has learnt that NHS England has yet to agree to uplift the value of a QOF point to match the increase in practice list size in 2014/15 potentially exposing practices to QOF losses of £2,000 for the average practice even if their achievement remains the same as in 2013/14.

Official documents published alongside the GP contract deal show that the average patient list size has risen by 2% between 2013 and 2014, from 6,911 to 7,052, meaning that practices will also see the total value of their QOF achievement reduced by the same amount if there was no increase in the value of a QOF point.

GPC deputy chair Dr Richard Vautrey said: ‘There is an issue for 2014/15 in that, as you can see the value of each QOF point has not been increased to compensate for this year’s new average list size. This is because NHS England have insisted that this should be a separate negotiation from the just concluded contract changes for this year.’

‘There is a risk that unless this issue is resolved there will be small but annual losses to the value of QOF each year. This is unacceptable and we are pushing NHS England and NHS Employers to agree to resolve this.’

Commenting on the scale of concerns, GPC negotiator Dr Peter Holden said: ‘Because it was going to be cost neutral, they were supposed to also push up the value of a point. That was the deal. It was supposed to be automatic – that is what was agreed when they decided to change the CPI. Because if you reduce the argument to the absurd, if every practice in the country merged then the Government would be getting the entire QOF delivered for £120,000. My view is that if the Government is doing this, then it is straight deception.’

Dr Gavin Jamie, who runs the QOF Database website, said: ‘Even with the new, slimmer, QOF this decrease will wipe out the majority of the 0.28% [DDRB] uplift to GP payments this year.’

NHS England did not supply a comment despite repeated requests to do so.