The QOF could be suspended within days in cities where GPs are being swamped with swine flu cases, as the virus continues to spread across the UK.
Last week, health officials in Birmingham warned that the spread of the virus was 'out of control' with the city accounting for almost half of all UK cases.
GPC lead negotiator for pandemic flu Dr Peter Holden told GP newspaper that the QOF should be suspended with immediate effect in parts of the country. He said the workload for GPs in the worst-hit areas was becoming unsustainable.
'I think we are at alert level three in the UK and that would signal the suspension of the QOF and other work, such as appraisals, in favour of following command and control procedures,' he told GP.
Some GPs had already been ordered to drop non-essential activities to focus on swine flu, Dr Holden said. 'In one area in Scotland, GPs have been told to focus on swine flu patients.'
Dr Fay Wilson, a GP whose out-of-hours co-operative BADGER has been tackling the outbreak in Birmingham, said QOF suspensions were imminent: 'I would not be surprised if the QOF is suspended in a week's time in areas like Birmingham, London and Glasgow.
'GPs are coming under severe pressure here in Birmingham. Our out-of-hours service has just experienced one of its busiest weekends, receiving more than 4,000 calls.'
A similar situation is likely to be seen in London, with containment plans moving toward mitigation, she added.
Swine flu hotspots
A spokeswoman for NHS Greater Glasgow and Clyde told GP newspaper that plans to suspend the QOF were being kept under review depending on workload. Any decision would be made in consultation with the government, she said.
Under DoH guidance, practices that 'actively participate' in the pandemic response will have NHS income streams protected at the previous year's levels.
Joint BMA/RCGP guidance states that UK alert levels should be introduced once the WHO has declared a pandemic.
But a spokeswoman for the DoH said that the UK alert levels will not automatically come into play. 'At the moment we are just monitoring the situation, and are still focused on a policy of containment.'
But Dr Holden called on the government to urgently issue the UK alert levels to help practices plan for a pandemic.
'We are approaching the summer holidays when about half of the practice staff will be away on holiday. We need to have time for practices to be prepared.'
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