RCGP calls for streamlined QOF as GP incentives consultation closes

Exclusive The QOF has a future role for general practice but there is scope for streamlining it, the RCGP has said in its response to a crucial Government consultation.

The incentive schemes consultation launched in December and closed yesterday, most notably asking respondents whether ‘incentives like QOF and IIF should form part of the income for general practice’.

To this question, the RCGP responded that it neither agreed nor disagreed, but it expanded saying it believes ‘there may be some scope for streamlining incentives schemes and reducing the number of indicators’.

It recommended a ‘significant reduction’ in the number of QOF and IIF indicators – to retain in the region of only five QOF and two IIF indicators – and a move to ‘higher-level and higher-trust’ indicators.

It stressed that when that happens the attached funding should be ‘transferred into core funding’.

And it added: ‘We recognise that there is likely to be a continued role for incentives schemes within general practice in some form.’

Other areas of consultation saw the RCGP setting out a stronger position.

Although it still said it neither agreed nor disagreed to the question of whether ‘continuity of care could be improved if included in an incentive scheme’, it argued this would not be ‘the most appropriate way’.

Its response document, shared with Pulse, said there could be ‘a limited role’ for incentives in encouraging ways of working ‘which promote continuity of care’.

But it stressed ‘a need for flexibility in providing continuity in the ways that works best for practices and local populations’.

‘There is also a need to recognise the limitations imposed by workforce, workload and premises challenges which may make it difficult for continuity to be consistently achieved,’ the document said.

‘On this basis, we would suggest that any efforts to support or improve continuity should be quality improvement based and properly resourced as a core role of general practice.’

The College also said it disagreed that patient experience of access could be improved if included in an incentive scheme.

It argued that incentivising a focus on speed of access ‘risks having the consequence of reducing opportunities to provide continuity of care’.

It said: ‘The workforce and workload crisis facing general practice, will continue to influence patient experience of access, regardless of incentive schemes.

‘The priority should be ensuring a properly resourced general practice able to provide a good experience of access rather than on setting targets via incentives schemes that practices may not be sufficiently supported to be able to achieve.’

The College also ‘does not consider it appropriate’ for an indicator on patient choice to be included in any GP incentive schemes.

Rather than using incentive schemes to set targets ‘which may be unachievable’ in the context of current pressures, the focus should be on ensuring practices ‘are sufficiently resourced to offer patient choice where appropriate’, the RCGP said.

In an exclusive interview with Pulse earlier this year, NHS England national director of primary care Dr Amanda Doyle told Pulse this consultation would ‘inform’ NHS England’s ‘long-term approach’ when negotiating contract changes for 2025/26.

In the meantime, as part of changes to the GP contract in 2024/25, GPs in England will see part of the QOF income-protected from 1 April, including a number of indicators on mental health, asthma, smoking and cancer.

The new GP contract will also ‘explicitly require’ practices to consider continuity of care when a patient makes contact.