GPs in Northern Ireland have been told they will lose their protected payments from QOF and enhanced services unless they staff Covid centres.
This is the latest update on the long-running disagreement regarding the centres,which have been set up across Northern Ireland to assess patients with coronavirus symptoms.
Northern Ireland’s Health and Social Care Board (HSCB) told Pulse that only five practices have declined to participate in staffing the centres.
Anonymous GPs from these practices have claimed they have legitimate reasons why they are not able to take part, including distance, staff pressure and health reasons.
Now they have been told that they need to resume QOF reporting and enhanced services in order to secure related payments.
Although these payments were given protected status by the NI Government at the start of the pandemic, a letter from the HSCB to practices sent 2 December said that ‘in standing down these elements of the contract, practices were required to fully engage and commit to the Covid centres to help manage the crisis’.
It added: ‘Non-participation in the rota for Covid-19 Centres will mean that your practices will be expected to meet QOF targets and QOF payment for 2020/21 will be based on upon actual achievement as per the Standard of Financial Entitlement (SFE).
‘Enhanced Services will be paid based upon actual practice activity carried out to the terms of the relevant service specification.’
The letter, signed by HSCB head of general medical services Dr Margaret O’Brien, stressed that the Covid centres had ‘been an instrumental part of general practice’s response to the pandemic’.
She told GPs: ‘Whilst the majority of practices have contributed to these centres a small number including your own have decided not to participate in the operation of the Centres.
‘I would urge you once again to reconsider your decision in this regard. I would be grateful if you could complete the return attached to notify HCSB of your intentions going forward.’
But a GP who received the letter, based just outside Belfast, told Pulse: ‘Being a single-handed GP, I can’t be in two places at one time – the door would have been shut for my patients.’
Another GP, based in a rural practice and who wished to remain anonymous, said: ‘Obliging some practices at this late stage to engage with QOF etc increases risk for patients and practices. Having to bring in COPD patients for QOF purposes is just not acceptable in the midst of a pandemic, for example.
They added: ‘Adding to workload and stress at this time is irresponsible and this letter ought to be withdrawn immediately.’
The GP also said that they wished the BMA would ‘respond to the letters being issued’.
‘They have previously stated that they would support practices who opt to care for their own Covid and suspected Covid patients,’ they said.
The GP further suggested it was ‘petty’ by the NI Government to claw back the QOF and enhanced services payments from a small number of practices.
However, an HSCB spokesperson told Pulse: ‘Only five GP practices across Northern Ireland have chosen not to take part in supporting Covid Centres during the pandemic.
‘It is clear from the agreement between the Department of Health, the HSCB and the NI General Practice committee that easements against elements of the regular GP contract were to acknowledge the GP contribution to Covid centres.
‘It is therefore appropriate that GPs who do not wish to be part of the GP Covid centre response should continue to meet their targets under the regular GP contract, and this includes meeting QOF activity and reporting.’
BMA NI GP committee chair Dr Alan Stout said: ‘We have ensured that any Covid centre work is non-contractual and that practices have the full choice in whether or not to avail of the agreement we have reached with the Department of Health on this area of work.’
According to the HSCB, Covid centres are staffed by GPs, nurses and other support staff to treat patients who have tested positive for or are suspected of having Covid-19 in the community. Patients have to be referred to these centres by their own GP or by GP Out of Hours.