QOF could be replaced with annual reviews, BMA GP leaders propose

The BMA’s GP Committee has revealed some of its proposals for what a new GP contract – and the negotiations process – should look like.

However, it has so far seen ‘no progress’ around the Government’s promise for a new wholesale GMS contract, it added.

In a webinar for BMA members which took place yesterday, leaders of the union’s GP committee said they are ‘still waiting’ for detail about the new contract negotiations and that the process ‘could be a lengthy one’.

They also revealed that some of their asks for the new contract include replacing QOF with ‘much more simplified models’, such as annual reviews.

They further stressed their involvement in the contract’s development was imperative; and said that the new GP contract should be put out to members to vote on once it is has been finalised.

GPC England chair Dr Katie Bramall said that in the new contract the funding ‘has got to follow the patient’ to ’protect and prioritise’ the GP partnership model.

She said: ‘We’ve got to replace QOF with much more simplified models, for example, annual reviews that can use the best of terms of targeting certain populations with the technology we now have, and thinking how we can do that better in the future.

‘But the ultimate goals and vision are for safety and for sustainability: safe workloads, protecting GP autonomy and maintaining or trying to bring back continuity of care.

‘There’s something here about restoring trust, rebuilding professional trust, and recognising GPs as the bedrock, the foundation of community health.’

GPC deputy chair Dr David Wrigley told the webinar that the new contract has to make sure that partnership is ‘viable’.

He said: ‘At the moment, we’re still waiting for some details, for some meetings and starting that process, which could be a lengthy one, and it must involve the BMA.

‘It must have the GPC as your elected representatives first and foremost. And it must have the ability for you as colleagues out there to have a say on that contract, because that’s your livelihood as a contractor.’

He also reiterated that BMA’s asks for the Government have been around getting the GP-to-patient ratio down.

He added: ‘We’ve got far too many patients on our list. A full-time equivalent GP now has 2,300 patients. It keeps going up, we need to drive that right down so that that means you have more time for patients, and they’ll have more time with us.’

On the review of the Carr-Hill formula currently being carried out by the Government, he said that ‘we can’t use the same funding and redistribute it’, because this will generate winners and losers, and that is ‘not acceptable’.

Dr Wrigley added: ‘We need a fair formula that gives a rising tide. The Government’s commitment is to give more funding to areas of deprived populations, and we don’t have arguments with that, but we’ve got to ensure that everyone has a fair funding model.’

It comes after Pulse exclusively revealed last month that the Government said ministers will be bringing forward proposals for a ‘reform of the GMS contract’ in ‘the new year’.

Health secretary Wes Streeting had reaffirmed his commitment to a ‘substantive reform of the GP contract within this parliament’ in a letter to GPs in December.

But Dr Bramall said yesterday that there has been no movement on the promise of a new contract so far.

The GPC is currently in dispute with the Government over a lack of progress in negotiating a new GMS contract, as well as access changes and the 10-year plan.

Dr Bramall said: ‘We’ve seen no progress around a new GP contract. We cannot allow rearrangement of the deck chairs that will bring such volatility, we will see so many more practices fold. We’ve got to fund it with the transition from acute to general practice.

‘We have to genuinely prioritise continuity of care in our workforce planning, which must be GP led. If you can have a GP do it, a GP must do it, that is best. Otherwise, it is a false economy.’

She said that the new contract is expected to involve a ‘wide consultation by Government’, but the negotiation ‘must be between government and the BMA’, and it must ‘end in a ballot’ of the profession.

She added: ‘That’s what’s important, because there’s got to have that sense of professional autonomy, if we do get into meaty discussions about a new contract, which will take quite considerable time.’

Pulse has contacted the Department of Health and Social Care for comment.

Meanwhile, the consultation on the 2026/27 GP contract has now concluded, with the Government expected to present the terms to the stakeholders by the end of February. Following that, the GPC will hold an ’emergency’ meeting to consider proposals.

GP leaders also hinted at what shape future GP collective action could take, including GPs uniting behind a new AI-powered OPEL-style framework that would enable closing of services.