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That’s a quality framework

I know I do bang on about QOF. But as an emblem of micromanagement in general, and of Covid-related jiggery-pokery in particular, it sure takes some beating.

You’ll recall that, in the early days of the pandemic, when gratitude and promises were being sprayed about like coronavirus droplets, we received, or thought we’d received, a promise that QOF would be income protected.

Then there were hints that ‘income protection’ is, like ‘Government policy’, a phrase that is open to interpretation: QOF would be adapted, points recycled, your inside leg measurement incorporated, and so on.

And now we have the detail. Which reveals that, in fact, only about half the total QOF points will be income protected. And even that ‘guarantee’ comes with strings attached: by November we must agree a detailed plan that prioritises those most vulnerable to Covid, habitual defaulters and other odds and sods.

‘Income protection’ is, like ‘Government policy’, a phrase that is open to interpretation

A whopping 257 points remain performance-related, and involve more smoke and mirrors. The ‘double points’ for flu and cervical screening are recycled, not new. And payment for the disease registers are conditional on practices maintaining disease prevalence at around 2019/20 levels – which is tricky given that the QOF-standard diagnosis of asthma is currently unobtainable unless you have a secret stash of FeNO monitors and a hermetically sealed spirometry room.

Finally, there’s the QI section. We were assured that, compared to the previous version, this would be ‘focused’. So why, then did it give me blurred vision? Handy tip: spare yourself seven pages of agony by skipping to the QI reporting templates at the very end of the document. Providing these is like giving the answers to a test in advance, which seems out of character for a government which has shown itself to be so adept at handling school exams.

On the other hand, starting at the end and working backwards seems appropriate – having to do all his with only six months of the QOF year left has me thinking, FOQ it.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at

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