Controversial 'quality premium' payments to go ahead

Plans to financially reward commissioning groups that improve outcomes and hit efficiency targets look set to go ahead despite widespread opposition from GP leaders.

Sir David Nicholson: quality premium detail before Christmas (Photograph: JH Lancy)

At the National Association of Primary Care (NAPC) annual conference in Birmingham last week, NHS chief executive Sir David Nicholson said details of how 'quality premium' payments would work would be released before Christmas.

RCGP chairwoman Dr Clare Gerada branded the payments a 'perverse incentive' at the college's annual conference last month. The BMA has also called the plans 'unethical'.

GPC deputy chairman Dr Richard Vautrey said confirmation that the quality premium would go ahead was 'bad news for the health service'.

He said the current plans risked 'undermining the doctor-patient relationship and widening health inequalities'.

'It would be far better to place more emphasis on peer encouragement and be open about the achievements of particular CCGs,' he said.

Doing this would help to avoid the conflict of interest that would arise from having resources directly linked to GP pay, he said.

Meanwhile, Sir David, also chief executive of the NHS Commissioning Board (NCB), said he wanted to see 'innovative' ways of working with clinical commissioning groups (CCGs) to give more power and control over primary care commissioning. 'I think we need to do some experiments,' he said.

'It seems it is a very important lever for the CCG working collectively to have more control over the commissioning of primary care.'

Dr Vautrey warned that the NCB would have to be 'very careful' about this plan.

He said: 'We would be very concerned if a CCG took on this role without fully addressing conflict of interest issues.'

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