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Wales ‘practically gets rid’ of QOF as only disease registers remain

GPs in Wales will only be required to maintain disease registers under a greatly pared down QOF agreed under the contract for 2018/19.

In an attempt to relieve workload pressures, the vast majority of QOF indicators will be inactive with the exception of flu.

The cluster network domain has been reduced to taking part in five meetings in a year.

It comes after a history of QOF suspensions in Wales – including for the first three months of this year – in response to increased pressure and workforce shortages.

The BMA and Welsh Government have begun negotiations on a an overhaul of the GMS contract, with an announcement expected next year.

A number of models around triage and use of multidisciplinary teams are being considered although negotiators have said there is unlikely to be a one-size-fits-all approach.

Working groups have been set up in Wales to inform negotiations around workforce, minimising risks, cluster development, funding, demonstrating quality and integration.

The GPC had previously said that the QOF was not likely to be scrapped completely from the contract – at least not anytime soon.

But the 2018/19 agreement suggests divergence between policy in Wales and England, where there were no changes to QOF pending a review due to complete next year.

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In Scotland, where a new contract will come into force in April, the QOF was abolished in 2015.

Dr David Bailey, GPC Wales negotiator said: ‘The inactive QOF indicators will still be paid through the same mechanism so that the funding remains identifiable for further contract negotiations for next year.’

QOF expert Dr Gavin Jamie, a GP in Swindon, Wiltshire, said in practical terms Wales had ‘probably got rid of QOF’.

‘In terms of what practices have to do for QOF, there’s really not that much there anymore.

‘But leaving disease registers, that does mean an adjustment to the global sum so they will get funding for how much disease they have which is not a bad way to fund general practice.’

He added: ‘Most of the stuff in QOF is really stuff that practices will be doing anyway. This is a fairly good half way compromise.’

Wales and Scotland had appeared to be more flexible in their ability to make changes or suspend parts of the QOF, he added.

‘We are seeing smaller countries being more dynamic and light on their feet around this.’