Exclusive: Bid to swap 60 QOF points for extended hours

The DoH plans to take 60 quality points from the clinical domain to fund extended hours.

Dr David Haslam

A senior DoH official has said that the points - worth £7,476 to the average practice - will be taken from the clinical domain of the quality framework in 2008/9 and given to practices offering appointments in the evening and at weekends.

Taking 60 points from the domain will reduce its value from 655 to 595 of 1,000 available points.

'It is going to happen,' said Dr David Haslam, clinical director of the National Obesity Forum and a GP in Hertfordshire.

He said that a senior DoH source told him of the plans in one-to-one sessions at the Labour Party conference held in Bournemouth last month.

'As far as general practice is concerned, it's a disaster,' said Dr Haslam.

The GPC and NHS Employers are expected imminently to make an announcement about changes to the quality framework for 2008/9.

Chairman of the NHS Alliance Dr Michael Dixon said adding access to the quality framework was to be expected.

'If access is a problem for patients then access should come into the framework. It should be seen as a change of emphasis,' he said. 'But GPs can't be expected to do more without getting more.'

Extended hours featured heavily in the interim report 'Our NHS, Our Future', by health minister Lord Ari Darzi, published last week. He wants more than half of GP practices to offer evening or weekend surgeries.

But GP practices may receive no extra income for offering this service if points from the clinical domain are used to fund extended hours.

Currently, GPs pay 6 per cent of their global sum (around £6,000 per GP) to opt out of 24-hour care.

The Darzi report also suggests PCTs use funds to commission private providers to do the work that practices will not.

Dr David Jenner, NHS Alliance GMS contract lead, said: 'Sixty points from the quality framework wouldn't be enough to fund extended hours. Recycling money is not new money.

'If they want people to open up and employ people to work longer and harder, the profession would expect real funding.'

Dr James Kingsland, chairman of the National Association of Primary Care, said the principle of extended hours had merit.

However, he added: 'If access becomes a quality framework point it will not be sustainable. It'd be a short-term fix.'

There are also concerns about what will happen to clinical care if points are usurped for access.

Dr Graham Archard, vice-chairman of the RCGP, said there was no evidence that extended hours would improve outcomes for patients.

The GPC and DoH declined to comment while contract negotiations were ongoing.


The DoH plan

  • Switch 60 quality framework points from the clinical domain to fund extended hours.
  • Worth almost £7,500 per practice.
  • Clinical domain quality points will fall to 595 of 1,000 available points.
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