Revealed: GP anger over 'ridiculous' QOF and DES work

GPs have told of their growing disillusionment with the QOF and enhanced services in an exclusive survey by GP magazine.

'There are no longer enough hours in the day'
'There are no longer enough hours in the day'

The survey of 1,173 GPs from across the UK shows rising workload has forced practices to give up chasing QOF targets and reject new directed enhanced service work - even though it will cost their practice income.

Below are a selection of comments made by GPs completing the survey.

On new DES work:

Not selecting schemes that we cannot deliver as we are already working 10 to 12 hours per day. There is no time nor resources to do more.

We are already working more than full time, we estimate that we now leave an hour later than we did 10 years ago when it was 1900. We have no breaks in the day and simply run from one to the next to the next etc. All of us can't wait to retire because of constant change and [increasing] pressure with no support or respite.

We can't afford not to do these extra tasks, our income is sinking.

It has really got overwhelming and impossible to keep up with all this. Our income will plummet and our semi-rural practice may have to close unless the government changes the current year's QOF etc back to where it was. Nearest practice is about 5 miles away and they are of course in same position.

The remuneration is not worth the effort and I'm sceptical about the benefit to patients.

It remains to be seen whether some of the DESs are achievable but we will try nonetheless on the basis of trying to maintain income levels.

The dementia screening will inundate the elderly mental health services and prevent people who need to be seen from being seen promptly. I can see the improvement of patient online access being a good idea in the ideal world. We are working at max capacity and expectations are unrealistic.

Can't afford not to, as losing organisational QOF points.

A real shame these are going ahead despite the evidence of lack of benefit.

On the QOF:

Some of the new QOF is ridiculous e.g. GPPAQ, and will contribute nothing to patient care. The targets have been raised to reduce earnings not to improve care.

QOF is out of control, we have reached our limit. It Is interfering with proper patient care.

I believe we will sink but can't even plan to do so as we live in hope things will change. Two of four of us will probably retire which will have a really destabilising effect.

There are too many changes to remember between QOF, DES & LES. Some of the targets just seem stupid, pointless & thought up by someone who has no concept of GPs' work. It doesn't help patients - just adds pointless admin work to an already overburdened system.

Though we are a high functioning practice with an excellent reputation we are struggling to cope and unable to offer our usual excellent level of care in light of massive PMS budget cuts and rising patient numbers and workload - the doctors suffer most and will flee!

BP thresholds & targets require a dramatic increased effort which we will ignore. Calculated time [versus] points suggest is not worthwhile.

We have run out of steam and capacity and pointless QOF work will have to be dropped.

We are planning for multiple £10,000s reduction in a 10,000 population practice.

Some QOF targets are unachievable, and others are poorly evidenced and we are not convinced of their value in patient management. We will continue to deliver those elements of clinical value to the patients and not those that are not.

There are no longer enough hours in the day - once a joy to practise, now a misery.

We will continue to jump through the ridiculous hoops to ensure we get paid.

It is not possible due to workload, time and money to strive to hit all QOF indicators as highly as in previous years - decisions have yet to be made on which ones will be targeted and which "ignored". These decisions are largely being made on benefit to patient care and time intensiveness.

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