Exclusive: GPs back scrapping QOF to ease practice workload

More than three in five GPs believe the QOF should be scrapped across the UK to ease workload, a GPonline poll suggests.

A decade on from the framework's introduction a year after the 2004 GMS contract took effect, a majority of GPs now believe the pay for performance system has run its course.

A total of 62% of 312 GPs who responded to the survey said it was time for the QOF to be scrapped, while 27% said it should remain, and 11% were unsure.

In a similar poll carried out in 2015, just 47% of GPs called for the QOF to be scrapped completely, with many saying it should simply be scaled back.

QOF targets

The QOF has been reduced in scope dramatically in recent years, with all four UK nations reducing the proportion of GP funding delivered through the framework - although practices' performance even on dropped indicators continues to be monitored. In Scotland the QOF has been dropped altogether for the 2016/17 contract.

GPs in Scotland were split on whether dropping the QOF had eased workload. A total of 40% said workload had not eased, 33% said it had, while 27% were unsure.

As part of the GP contract deal for 2016/17 in England the GPC and the DH have committed to explore ending the QOF and unplanned admissions enhanced service from April 2017.

Some GP leaders have warned against throwing the baby out with the bathwater if the QOF is scrapped altogether, arguing that it has helped to raise overall standards even if the framework has increased the bureaucracy practices face.

One respondent to the survey echoed these comments, warning that it was important to ensure that the good elements of QOF were retained and financed.

RCGP warning

But pressure to move away from the system has been growing, with an RCGP report last year calling for it to be replaced with an alternative payment mechanism.

Another respondent said of the QOF: 'A lot of it was never evidence based, and the tick-box culture and rules and regulations were absolutely preposterous and got in the way of patient care.'

Practices that take up NHS England's offer of alternative arrangements that would bring groups of practices together under a joint multispecialty community provider (MCP) contract will also be allowed to drop the QOF, while retaining their GMS contract status under plans announced last month.

The GPC hit out this month at new QOF targets proposed by NICE, warning it was 'totally opposed' to proposals to incentivise GPs to record the BMI of all adult patients every five years.

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