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Quarter of QOF indicators to be scrapped under new proposals

A quarter of QOF indicators could be cut under new proposals drawn up following a review of the framework.

The indicators that are to scrapped will be discussed following an ‘engagement exercise’ with GPs and other stakeholders, launching today.

The consultation comes after a review of the framework involving representatives from the BMA’s GP Committee, RCGP, NICE, Public Health England, Department of Health and NHS England.

Proposals for a reformed QOF come despite the head of NHS England, Simon Stevens, saying that QOF needed to be done away with entirely.

Despite fewer indicators, NHS England said the proportion of practice income that QOF contributes will remain the same.

Instead, practices will be able to choose from a list of ‘quality improvement’ options that will be agreed nationally and locally.

The RCGP told Pulse in May that GPs would be able to choose from a ‘menu’ of other services – such as for example obesity services – for which they would get paid.

The proposals also suggest that between a third and a half of the indicators will be updated to reflect NICE guidance.

The report also suggests a more personalised approach to ‘exception reporting’, which will allow GPs to make a clinical judgement over whether a patient needs to – for example – have their blood pressure checked if other attributes of the patient suggest otherwise.

Meanwhile, the report also proposes meeting QOF targets as a network of practices, which NHS England has said will be trialled first.

NHS England told Pulse the purpose of the QOF changes are to recognise the pressure practices are under, to create stability for general practice and so GPs aren’t over burdened by what they need to do in relation to the scheme.

Following the engagement exercise, which is open to all GPs from today until the end of August, the feedback will be discussed with the GPC during the contract negotiations for next year. 

NHS England said the earliest changes to the QOF will be implemented is April 2019, when the new contract comes into effect.

However, it added that some changes may take an extra year to put in place.

Ian Dodge, NHS England’s national director for strategy and innovation said: ‘2019 starts the most substantial discussion of the GP contract since 2004 – given the forthcoming long term NHS plan, current pressures on general practice, the emergence of primary care networks, QOF and indemnity reform, the partnership and premises reviews.

‘This calls for more intensive joint working between NHS England and our partners, particularly the BMA, and I look forward to constructive and fruitful discussions with Richard and his team.’ 

BMA GPC chair Dr Richard Vautrey said: ‘In the year the health service turns 70, we need to take serious steps to address the fundamental issues facing general practice, from workload and workforce pressures to unsustainable indemnity costs and problems with premises.

‘NHS England’s commitment to work with us to address these and other issues which we have repeatedly highlighted is welcome.

‘We have been pleased to work with NHS England and other partners, to review QOF and produce a report that will stimulate further discussion, given the BMA has been calling for a review of QOF that both provides stability for practices and better enables them to respond to the needs of their patients.’