Exclusive: PCTs defy BMA over quality bonus

PCTs are already planning bonus payments for consortia that hit savings targets, despite BMA calls for the performance-related 'quality premium' to be scrapped.

Dr Kingsland defended the 'sophisticated' quality premium
Dr Kingsland defended the 'sophisticated' quality premium

The White Paper Liberating the NHS and later policy documents set out plans for a quality premium to be paid to consortia based on patient outcomes and successful financial management.

The GPC has urged the government to remove the plans from the Health Bill, warning that rewarding consortia for financial performance could undermine patient trust.

But some PCTs are planning to hand consortia financial incentives for hitting targets around the Quality, Innovation, Productivity and Prevention (QIPP) agenda.

NHS Berkshire East is planning to distribute a £380,817 funding pot between three consortia if they deliver on QIPP targets for cutting elective and non-elective activity.

NHS Surrey is understood to be considering a £2.35 per patient payment for achievement of QIPP targets. Other trusts' board papers suggest they have similar plans.

Jacky Walters, assistant director of primary care at NHS Berkshire East, said its targets would focus on referral activity.

The scheme was at the planning stage and final details had not been determined, she said. But the money available to consortia would fund GPs' time spent achieving the target.

DoH national clinical commissioning network lead Dr James Kingsland said it was a 'fairly clumsy' approach. 'We are not going to change attitudes with financial incentives to change activity,' he said. But he defended the quality premium, which he said would be a sophisticated means of improving quality. GPC deputy chairman Dr Richard Vautrey said incentive payments offered by PCTs should be handled carefully.

'If a doctor is being paid not to do appropriate things, then there needs to be real caution with progressing with such schemes,' he said.

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