GPs are currently part reimbursed through the Quality and Outcomes Framework (QOF), which was rolled out as part of the new GP contract in 2004. As we all know, QOF is a mechanism for performance measurement and payment, and therefore play a vital part in GP remuneration.
Various aspects of care are currently measured and reported by the Quality Management and Analysis System (QMAS), which will make QOF payments for the last time this year.
From April 2013 it will be replaced by a more versatile service called the Calculating Quality Reporting Service (CQRS) which will also be used to replace existing manual systems for determining achievement and processing returns.
So why the change? QMAS is limited in what it can extract from the patient record and, with the need for both practices and CCGs to demonstrate more of what they are achieving and be paid correctly for this work, a more adaptable system was needed.
The GP patient record is the most complex record within the NHS and, if analysed carefully, could allow health policy to truly reflect the needs of the population. GPES will become the only national means of extracting data from GP clinical systems, and will allow approved third parties to access anonymous data for research and national policy development (for a fee, payable to the Government).
GPES will be used to provide the data to CQRS that will support payments made through the QOF. CQRS can also be used for any LES or DES payments, and will allow CCGs to demonstrate target achievement in various clinical areas.
At practice level, data from our clinical systems will be automatically extracted to demonstrate what services we have been providing. It’s hoped this will save us time, as these processes will no longer need to be done manually.
It’s important to note that our patients have a right to know their data is being used in these ways. But we’re still waiting on guidance about how this information is to be disseminated.
When a third party is approved to request anonymised data from a practice via GPES, the practice is notified and has the option to accept or decline. But careful – it would be unwise to decline the baseline data extraction as your QOF payments will depend on this information. ‘Big Brother is watching’, you might say…
Dr Hadrian Moss is a GP in Kettering, Northamptonshire. You can tweet him at @DrHMoss.