Editorial: DoH must close the door on local QOF funds

If ever there were any doubts about the value of the quality framework, they should have been dispelled by recent events.

The QOF is one of the most effective ways of incentivising changes in health behaviour, according to a DoH report. That report was even cited by health secretary Alan Johnson in a speech on public health last week.

Health England, the DoH body set up to implement the Our health, our care, our say White Paper, also stressed the importance of ensuring that PCT funding for public health schemes is ring-fenced.

The importance of ring-fencing cuts both ways. It is interesting that in the DoH response to the QOF consultation the door is left open for local QOFs, with no explicit percentage of funding mentioned for this in practice.

Summarising the evidence, the consultation response says that of those respondents who supported local QOFs, the majority said that no more than 5 per cent should be made available for local decision-making initially.

However, in the DoH response no percentage figure is mentioned. It says only: 'The government - with the support of the NHS - believes that the local NHS should in principle have a greater say in how investment is used to the benefit of their populations.'

Alarm bells should ring at the response from the NHS Confederation's PCT Network, which wants 'a stronger commitment' from the DoH on promoting a more local element to the QOF.

The DoH is already saying that indicator changes will be annual and could even be within a financial year in certain circumstances.

QOF is a success story and too much meddling with it over a short period risks diluting its value.

The DoH must ring-fence the national value of QOF and resist attempts by primary care organisations to claim any percentage of funds from within it for their own schemes. The best way to pay for these is through local enhanced services.

MORE OPINION ONLINE

Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs. This is what the team had to say this week

  • "Dealing with stress in the recession Doctors are calling for extra resources for patients struggling to cope with recession-related stress and anxiety. Bearing in mind the rise in unemployment, I say the government should look at this urgently."
  • "NHS managers in reality TV show But what similarities can there be between a BBC ballroom and an NHS boardroom - apart from a load of old has-beens staggering around to constantly changing tunes until they're voted out by the public?"

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