Editorial - Now the clock is ticking for the QOF

As far back as 18 months ago, GP was urging contract negotiators to explore what GP life would be like without the QOF (GP, 13 September 2013).

At a conference of NHS Clinical Commissioners in London less than a year later, health secretary Jeremy Hunt suggested he would like to abolish it (GPonline, 2 May 2014).

A glance at our website, GPonline, after the Scottish LMCs' conference earlier this month (also reported on page 10) would reveal that delegates called for the QOF to be separated from practice income, in a move that could lead to the end of the pay-for-performance framework in the country.

The vote will shape the GPC's negotiating stance in talks that could lead to a radically different contractual framework for Scotland's GPs from 2017.

One GP even told the conference that QOF had helped to deliver high-quality care, but was now a real burden that got in the way of consultations.

Last month, the Welsh LMCs' conference heard how almost £16,000 per average practice would be moved from the QOF into practices' core pay from 2015/16 under a two-year Welsh GP contract deal.

At a time when GP recruitment is a struggle and workload, including the inevitable box-ticking generated by the QOF, is spiralling, it is common sense to assess the impact on practices and patients of cutting back or dropping the framework.

The latest Manchester University research tells us there is no link between practice scores and patient mortality (GPonline, 4 March).

Even NHS England deputy medical director Dr Mike Bewick recognised the QOF was becoming 'bad for health' (GPonline, 12 February).

There is just one message for negotiators now: QOF funding should remain in general practice but dependent on less, not more, bureaucracy. If that means time is called on the QOF, so be it.

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