DoH threatens to overhaul pay for enhanced services

A DoH scheme in which a proportion of funding is withheld from providers who do not improve quality could be extended to enhanced services.

Dr Vautrey: practices unlikely to agree to financially risky schemes

The Commissioning for Quality and Innovation (CQUIN) framework, used in the acute system this year, allows trusts to withhold 0.5 per cent of the value of a contract if agreed measures of quality and innovation do not improve.

Flora Swanborough, the DoH's CQUIN lead, said the department plans to expand the scheme into other sectors and increase the amount of money that can be held back from providers.

A DoH document published in October, Improving Quality in Primary Care, said that PCTs should consider incorporating the CQUIN framework into enhanced services and out-of-hours services.

NICE's clinical standards were an ideal candidate for CQUIN 'incentives', said Ms Swanborough, speaking at an NHS Confederation conference in London.

According to Audit Commission research presented at the event, 'the threat of losing money may motivate clinicians more than incentives'.

James Peskett, head of health policy at the Audit Commission, told NHS managers that the economics of 'prospect theory' could change the future of performance-related pay in the NHS.

The theory shows that people are more likely to respond to the threat of a small loss in income than the prospect of a gain, until incentives reach a certain size.

GPC deputy chairman Dr Richard Vautrey said he had heard 'chatter' about the use of CQUIN in primary care but had yet to see any detail.

He warned that it was unlikely that practices would want to participate in schemes that involved financial risk.

'Practices are already over-loaded with targets. Practices will always look at the bottom line with a contract like this, and decide whether it is financially viable to strive to achieve these targets, or whether they will actually end up spending more money than it is worth.'

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Just published

Kamila Hawthorne

GP crisis could force one in four practices to close, says RCGP

Unmanageable pressure could force more than a quarter of GP practices to close, polling...

COVID-19 vaccine in pregnancy

Vaccination in pregnancy cuts COVID-19 risk for mother and baby

Vaccination against COVID-19 during pregnancy reduces the risk of infection and hospitalisation...

Child using smartphone

NICE backs digital CBT games for children with anxiety or low mood

GPs could prescribe CBT-based digital games, videos and quizzes for children and...

GP surgery sign

GP pressure to continue as experts warn NHS backlog will remain through 2023

General practice faces continuing heavy pressure after experts warned that the record...

Close-up of a man loading a shotgun

BMA updates GP firearms guidance as digital marker goes live on EMIS

The BMA has updated its guidance for GPs on firearms licensing following the release...

Map pins

Severely underdoctored areas spread across nearly every NHS region

Severely underdoctored areas exist in nearly every NHS region across England, figures...