This could be the beginning of the end for the old-style QOF, with major parts of the framework due to be removed in April and the funding returned to the global sum.
For many GPs the changes in 2013/14 have been offset by the more relaxed approach planned for 2014/15. Looking back, the removal of 100 points from the management domain has not been a major issue.
Unfortunately the same cannot be said for the increase in achievement thresholds in 20 indicators and the shortening of the period for achieving them. If you find you have historically hit a certain level of achievement for a particular indicator – say, 60% – but the new threshold is 90% or 100%, you may want to make the tactical decision to stop chasing those points at this stage.
Talking to a range of practices I have found that while many are confident they should not see losses in QOF income for 2013/14, others are predicting income will fall dramatically.
Where practices are facing a significant reduction in income, it’s much better for the partnership if the GPs concerned see these losses coming. Nowadays we see many more practices breaking up than we used to five years ago, and shock financial losses are a typical factor.
I’d also advise practices to look at which indicators are being removed, and assess who was dealing with that work. Which staff members will see workload change, and by how many hours a month? If these staff leave or cut their hours, there are big savings available if they do not need to be replaced.
Preparing for next year
In these last weeks before the year-end, practices still grappling with the QOF should concentrate on the areas where the cost and effort of achieving the points is less than the income generated. The 2014/15 QOF is much smaller than this year’s but it has higher thresholds too.
If you’re worried about next year’s QOF workload, stick to the targets that will provide real clinical benefits. You already do this work, so the QOF won’t increase your workload (or at least, not by much).
Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at Baker Tilly