QOF set to be scrapped in Northern Ireland

Northern Ireland is set to scrap QOF in a contract deal that is expected later this week, with all the associated funding moving into the core contract.

BMA Northern Ireland GP committee chair Dr Alan Stout told Pulse that the deal will see the contract ‘simplified’, including moving all QOF monies into core contractual funding and all targets removed.

The contract should also include ‘significant movement’ on the issue of indemnity costs, he said.

This follows years of lobbying by BMA in Northern Ireland, which remains the last UK nation to have no state-funded solution.

The funding for some enhanced services is also expected to move to core funding.

Depending on DDRB recommendations and the Government’s budget, the deal should also include a commitment to a pay uplift for this financial year, Dr Stout said.

This comes as health minister Robin Swann recently signed off a retrospective pay uplift for GP partners and salaried GPs and other staff worth 6% for 2023/24.

Mr Swann was appointed health minister in February upon the reforming of a Government in Northern Ireland for the first time since 2022. He had said negotiating the GP contract would be an early priority.

Dr Stout told Pulse: ‘This was last year’s uplift which we have not had applied for the large part of the year mainly because we didn’t have a Government.

‘Almost as soon as the minister came in he made sure that it was applied, and that it was applied to general practice as well, and it landed in practices’ accounts at the end of March.

‘We had three key asks [during the negotiations] and one was that the uplift was applied, and a commitment to next year’s uplift as well, and that is going to be subject to budget – but there is that commitment there.’

Dr Stout said that in the short term the solution to the indemnity issue will be reimbursement of costs rather than a state-backed scheme, but that there are multiple options on the table for a long term solution.

He added: ‘The other key ask was indemnity and we will see something on indemnity which will be part of the short-term solution with a view to creating a longer-term solution. There is going to be quite significant movement on indemnity.

‘The third ask was to simplify the contract, trying to move as much as possible into core funding so that includes QOF and a number of the enhanced services as well.

Dr Stout told Pulse that all QOF targets would be ‘removed’ and that funding previously associated with the targets would be moved to core funding. 

‘It will hopefully start to provide stabilisation to our practices, but also it should start to change conversations because quite clearly they are trying within very strict constraints that they have at the moment, to give some sort of help and some sort of hope.’

Last month, Dr Stout urged GPs to hold off on handing back their NHS contracts as he said contract negotiations between the BMA and the Government had shown ‘definite encouraging signs’.

The deal marks significant progress for GPs in Northern Ireland as only last year their GP Committee had said it would ‘fully explore’ whether industrial action was an option for GP partners.

Pulse reported last year that close to one in 20 Northern Irish GP practices had handed back their contracts in just one year, amid the political standstill in the country which had seen DUP and Sinn Fein unable to set up a post-Brexit power-sharing agreement.

Earlier this week, an RCGP Northern Ireland report into GP retention highlighted a state-backed GP indemnity scheme as a key target to achieve.