The overall value of QOF points available to practices will not change significantly in next year’s contract, the GPC has confirmed.
Detailed negotiations on the QOF part of the 2015/16 GP contract are still ongoing, but the GPC told Pulse that clinical indicators will remain largely unchanged.
Negotiators also confirmed they have blocked the introduction of any of NICE’s proposed new menu of indicators – including a controversial ‘all-in-one’ bundled diabetes indicator. There will also be no change in achievement thresholds for any of the clinical indicators.
Last year’s negotiations saw a massive cutback in the value of QOF, reducing it by more than a third through the removal of several unpopular indicators that had been imposed the previous year, as well as the entire Quality and Productivity domain, in order to help reduce bureaucracy and ‘box ticking’.
The GPC previously hinted it would be looking to shrink the QOF further this year to continue the move away from box ticking, following comments from health secretary Jeremy Hunt appearing to signal further radical cutbacks.
However although detailed negotiations were still ongoing, GPC chair Dr Chaand Nagpaul told Pulse today that ‘the default is the current QOF, there is no change’ and GPs would certainly not see any new indicators in next year’s contract.
More on the new GP contract
In announcing the new GP contract today, NHS Employers said negotiations were ongoing regarding changes to the QOF clinical indicators, and that the full NICE menu of recommended QOF indicators for 2015/16 was still on the table.
NHS Employers said: ‘The [NICE] menu will be used to inform negotiations on the QOF between NHS Employers and the [GPC] as part of the wider [GMS] contract negotiations. Following negotiations, full details of any changes will be published on both the NHS Employers and BMA websites and the QOF guidance will be updated accordingly.’
But Dr Nagpaul, said although they were still discussing ‘some further changes and improvements’, if the GPC did not think they would be of benefit, ‘the current QOF will stand’.
He said: ‘[We] are not going to accept anything in the QOF that will add additional work for GPs. In fact.. we have managed to reject bundled QOF indicators.
‘The menu from NICE is about retiring some indicators but adding others. We have been able to avoid the inclusion of NICE recommendations.’
GPC deputy chair Dr Richard Vautrey told Pulse that negotiators had worked hard to achieve stability in the QOF, after grassroots GPs complained of ‘change fatigue’ with yearly revisions.
Dr Vautrey said: ‘There’s no change to the size of QOF or the resources within QOF, but the discussions are continuing about clinical changes.’
He added: ‘What others were thinking might happen is that there would be big changes to QOF in terms of significant reductions in the number of points. That’s not going to happen this year. What we’ve actually delivered is stability. One of the concerns which many GPs have been raising with us repeatedly over the last year is that they’ve got “change fatigue” and they are really worn down by the constant changes year after year in the contract.’
Dr Vautrey told Pulse some changes will reflect updates to existing indicators, such as AF003/4 that will need to be changed to replace the CHADS2 with the CHA2DS2-VASc risk score and remove the option of antiplatelet therapy, in line with the updated atrial fibrillation guidance published earlier this year.
Dr Vautrey said: ‘We know, for instance, that the guidance relating to atrial fibrillation has changed and so the current indicators relating to atrial fibrillation are out of line with current best practice – so we are going to have to make some changes within QOF to try and ensure that what we’re delivering is the proper patient care in line with best practice.’
NHS Employers has also confirmed that the value of each QOF point will this year be adjusted to take list size into account, after this was omitted in last year’s deal, leaving many practices out of pocket. And the planned hike in QOF thresholds – to raise the top achievement to the top quartile of practice performance – have been deferred for another year.
The NHS Employers website states: ‘[Changes to QOF]: adjustment of point value for 2015/16 taking account of population growth and relative changes in practice list size for one year from 1 January 2014 to 1 January 2015; deferment for one year of changes in thresholds planned for April 2015.’