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Scottish GPs vote to remove QOF from the GP contract

Scottish GPs have voted to remove the QOF from the GP contractual negotiations, with the chair of the Scottish GPC calling for it to be made ‘more flexible to communities’ needs’ instead.

Delegates at the Scottish LMCs conference have voted for a motion saying the QOF has delivered improvements ‘but [conference] feels… these aspects of care should be separated from GP practice income’.

Scottish GPC chair Dr Alan McDevitt told Pulse that the move away from the QOF will definitely form part of the 2015 contract negotiations, adding that QOF ‘needs to move on’, and be more flexible to local needs.

Proposing the motion, which was carried, Dr Neil MacRitchie of Grampian LMC said the QOF had achieved a lot.

However, he added, it had become ‘a target for every interest group to try and influence’, with too many diseases being included in the framework.

He said: ‘In any new contracts, I would suggest we might want to keep the good bits of QOF – common standards across the country for the management of chronic conditions in the community.’

But other groups – such as health and social care partnerships – could take on the responsibility, ‘using GPs to advise on management decisions for their registered patients’.

This would ‘lose the contractual element, which means a proportion of practice income is dependent on factors outside my control, such as the diet of my diabetic patient or, more importantly, my workload being increased on the whim of a minister who has been pressurised by a particular lobby’.

Dr McDevitt said: ‘The principles of QOF are sound and it did transform many aspects of care, but it needs to move on.

He said the operation of the QOF is being carried out by other staff.

However, he added: ‘I do have a professional responsibility to ensure it is delivered to a high quality. If we genuinely get cluster groups to work, your job is to ensure whoever is delivering that the quality is maintained. If it does not deliver, GPs should have the authority to fix that.

‘It should also be much more flexible to your particular community’s needs – not tied into a national structure.’

The vote comes as NHS England has allowed CCGs to replace the QOF with a local incentive scheme as part of co-commissioning.

The conference delegates voted against the motion to include 15-minute appointments in the contract, while a motion to introduce three-year contracts as a permanent fixture was taken as reference.