The rules will make clear circumstances when the government believes a quality premium would be inappropriate, and will limit how consortia can use the payments they receive.
The White Paper Liberating the NHS set out plans for a quality premium to reward consortia that improve patient outcomes and manage NHS budgets successfully.
But the BMA rejected the plans, warning they could offer a perverse incentive to reduce patient care.
In a policy paper responding to the findings of the NHS Future Forum, set up to lead the Health Bill listening exercise, the government said: ‘We will revise the provisions in the Bill on the quality premium, and we understand the concerns raised.’
The policy paper said the government would make it clear that the premium would ‘reward clinical commissioning groups that commission effectively and so improve the quality of patient care and the outcomes this leads to, including reducing inequalities in health outcomes’.
The statement said there would be ‘circumstances where it would clearly not be appropriate to award a premium, for instance if a commissioning group has achieved high-quality outcomes by spending more than the money allotted to it’
It added: ‘Great care will be needed to design rules on when a quality payment can be reduced or withheld to reflect factors such as these. We will also change the Bill so that regulations can be used to make provisions for how commissioning groups can use any quality payment awarded to them.’
GPC chairman Dr Laurence Buckman called the quality premium an ‘appalling notion’ in his speech to last week’s 2011 LMCs conference in London. He warned: ‘We will not agree to anything that gives patients the slightest perception that we might be making money out of reducing care to patients.’