Editorial: Busy practices need fair share of QOF pay

A list of FAQs on the BMA website explains that the QOF is meant to 'resource practices to deliver high quality care to patients by helping them employ the staff they need to offer quality, however many patients there are'.

But GP reports this week that flaws in the system for directing pay to the practices that need it most wiped out prevalence weighting across much of the QOF in 2009/10.

As a result, practices with disease prevalence well above the national average received the same pay per QOF point as practices with almost no prevalence in many disease domains.

The problem has occurred because a mechanism meant to uplift pay for practices with very low prevalence to guarantee them a basic level of QOF income has been distorted by practices reporting abnormally high prevalence. Bizarrely, practice list sizes and disease registers are not counted at the same time for QOF purposes.

Darzi centres with growing patient lists therefore had prevalence rates in some disease areas far in excess of 100 per cent - wiping out prevalence weighting for practices with disease rates in the normal range. In previous years, similar problems have occurred because care homes and a handful of practices that are effectively rooms in hospital wings have been included in the QOF, reporting disease rates above anything a standard practice would have.

Anomalous results like these have made QOF pay weighting unfair for several years.

From 2010/11, pay will be weighted for the first time according to raw prevalence, and the mechanism for supporting low prevalence practices will be removed.

This change will make QOF pay reflect workload more than it currently does. But it's hard to see why the statistical aberrations that have neutered QOF pay weighting year after year have been allowed to continue.

Tackling these may have been a fairer way to improve pay distribution than cutting support for low-prevalence practices, leaving university practices questioning whether they can remain in business.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

NHS sign

Plans to recruit 1,000 new link workers to support GP practices this winter

NHS England has set out plans to recruit an additional 1,000 social prescribing link...

BMA House

BMA prepares to ballot junior doctors on industrial action

Junior doctors will be balloted over industrial action if the government does not...

Typing on a laptop

NHS 111 systems could be offline until next week following cyber attack

NHS 111 systems could be offline until next week following the cyber attack on a...

The NHS App in the Apple App store on a smart phone

NHS England piloting online patient registration for GP practices

A new system that will allow patients to register with a GP surgery online is being...

satisfaction scale

Which parts of England have the highest and lowest GP patient satisfaction?

Patient satisfaction with GP services varies widely between PCN and ICS areas across...

Talking General Practice logo

Podcast: Improving menopause care

During August we’re bringing you some of the best interviews from series one of the...