Exclusive: Cuts to QOF trigger swings in GP income

GP practices face up to five-figure swings in funding under plans to recycle QOF funding into core pay from April, GP can reveal.

The vast majority of practices will see swings limited to four-figure sums, and GP leaders remain convinced the benefits of reduced bureaucracy will far outweigh any losses.

But experts said there would be winners and losers from the agreement to move an average of £37,000 per practice from QOF into global sum funding.

Swings in income from recycled QOF pay will add to uncertainty over 2014/15 funding, with the seven-year phase-out of MPIG top-up payments likely to begin next April.

Over the seven-year period, accountants have said that the removal of MPIG will trigger six-figure swings in income for the worst-hit practices.

Accountants warned of future uncertainty over possible changes to the global sum funding formula from 2015.

Details of how the QOF changes will be applied to PMS practices are yet to be revealed, with LMCs appealing for clarification.

GPC member Dr David Bailey said there would be 'winners and losers' from QOF cuts and there was uncertainty over how practices would be affected.

Laurence Slavin, a partner with specialist medical accountants Ramsay Brown & Partners, said the contract deal was positive for most GPs, but that high QOF performers with low list weighting could lose out (see 'Expert view' box).

Modelling of the transfer of QOF points into core pay in Wales found four-figure funding swings for most practices, and gains or losses of about £10,000 for outliers, Dr Bailey told GP.

In England, swings in income would probably be similar, Dr Bailey added, but outliers could be more pronounced because of the larger population.

For GPs with small swings in income, any losses from the 2014/15 contract would be a 'good payback for getting rid of bureaucracy', he said.

Derbyshire LMC secretary Dr John Grenville agreed there would be winners and losers, but said the overall result would be greater financial stability for practices.

Manchester LMC honorary secretary Dr John Hughes said any losses would be 'more than balanced' by extra staff time created by cutting QOF.

Dr Bailey said there was no evidence that practices with high correction factors would lose more than others on recycled QOF funding.

EXPERT VIEW - THE ACCOUNTANT

Laurence Slavin is a partner at specialist medical accountants Ramsay Brown & Partners

'The 2014/15 GMS contract looks much more positive than I first feared. It seems most practices should not lose out.

'I say "seems" because we have yet to be told how the core funding and global sum will be reallocated to practices.

'This is an extension of the issue with reallocation of resources following withdrawal of the MPIG. There are some peculiar potential outcomes: although the monies released back into core funding will not suffer the out-of-hours deduction, they will presumably be affected by the list weighting.

'A low-performing QOF practice will not suffer too much from losing the 341 QOF points, but might do well with these sums allocated back into the global sum, especially if the practice list has high weighting. Potentially worst affected will be a high-performing QOF practice with low weighting.'


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