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QOF will be reformed to remove ‘unnecessary indicators’

The GP quality and outcomes framework (QOF) will be reformed to bring in ‘clinically-proven improvements’ for the management of prevalent conditions such as diabetes and blood pressure control, NHS England has said.

The announcement, which comes as part of the new five-year GP contract, said the overhaul of the framework will also involve future improvements to the management of heart failure, asthma, COPD, and mental health.

The changes will remove ‘unnecessary indicators’, allowing for ‘professionally-led quality improvement’, according to the BMA.

This comes after the Government said last year that one quarter of QOF indicators would be scrapped following a review of the framework.

NHS England chief executive Simon Stevens previously said QOF was ‘nearing the end of its useful life’, and argued it had ‘descended into too much of a box ticking exercise’.

However, in the statement announcing the new five-year contract, NHS England said: ‘From April this year, clinically-proven improvements in the management of diabetes, blood pressure control and cervical screening, through reforms to the GP QOF, with further changes in the pipeline on heart failure, asthma, COPD, and mental health.’

‘New support for quality improvement, starting with prescribing safety and end-of-life care’ will also be provided, it said.

BMA said: ‘QOF changes to remove unnecessary indicators and provide a focus on professionally-led quality improvement.’

175 points from 28 indicators will be retired, following extensive analysis of all indicators which identified them as ‘low-value’. Of those, 101 points will be recycled in more appropriate indicators (15 new indicators) with the remaining 74 points creating a new Quality Improvement domain, the BMA explained.

For 2019, the quality improvement domain will include two modules – end of life care, and prescribing safety.

Other pledges made as part of the new contract include:

  • £1.8bn in funding to help set up the primary care networks
  • £300m in funding to help the networks achieve the outcomes of the long-term plan
  • 20,000 extra non-GP staff to support the networks

Commenting on the new contract, BMA GP committee chair Dr Richard Vautrey said: ‘This package sets us on the road to rebuilding not only general practice but also the wider primary health care team; delivering an expanded workforce embedded within practices and giving GPs a leadership role in bringing together the community healthcare team.

‘These changes present a real opportunity to demonstrate that GPs will lead the development of a more resilient community-based health service for the benefit of our patients for years to come.’

Last year, nearly half of GPs surveyed by Pulse said they want to see the QOF completely scrapped, labelling the paid-for-performance scheme ‘toxic’ and ‘onerous’