Government must scale back QOF and invest in GPs, says GPC

Bureaucracy and QOF targets must be reduced this year by the DH, and ministers must commit to a long-term investment in more GPs, practice staff and premises, the GPC has warned.

BMA: urging DH to invest in general practice

The demands came as the BMA published a poll on Friday of 3,629 GPs in England that found 97% believed ‘bureaucracy and box-ticking’ had increased in the past year. A total of 94% said they were working harder now than a year ago, and 86% said their morale had fallen over the past year.

DH-commissioned survey also published this week found that almost one in ten GPs aged under 50 plan to quit direct patient care in the next five years. The profession's stress levels have soared to a 15-year high, it revealed.

GPC negotiators, who have begun negotiations with NHS Employers on changes to the contract in England, called on the government to invest in general practice to tackle the crisis. Parallel negotiations are taking place in others parts of the UK.

In a speech this month health secretary Jeremy Hunt pledged to invest in more GPs, to give the profession ‘better support in managing demand’ and said that a ‘dramatic simplification of the targets and incentives’ was needed.

GPC chairman Dr Chaand Nagpaul said: ‘We want to help them deliver. We want to work with government to enable this expansion of general practice.’

He said that this would require ‘significant’ expansion of GP numbers, premises and practice staff.

A Leeds LMC QOF survey published this week found that 69% of the 83 GPs and 13 practice nurses who took part believed that the ‘method for raising thresholds’ introduced in April 2013, and those planned for April 2014, could harm patient care. The changes to QOF will ratchet up upper thresholds annually by forcing practices to match high performers from previous years to achieve maximum points.

A total of 71% of respondents said QOF targets that incentivise practices to offer annual General Practice Physical Activity Questionnaire (GPPAQ) checks to patients under 75 with hypertension, and a brief intervention to those deemed 'less than active', should be scrapped.

Quality and productivity indicators were also unpopular, with a total of 60% of respondents calling for the removal of a target encouraging plans to reduce avoidable A&E attendances.

On QOF, one GP responding to the poll said: ‘It has now grown out of all proportion and seems to be used by government as a way of reducing practice income by unattainable and nonsense indicators with possibility of harming patients. It is definitely demoralising.’

Another said: ‘Having to spend so much time on the QOF/QP, that the poor souls who are actually ill haven’t got a look in. Appalling how we have let it deteriorate to this state.’

Deputy GPC chairman Dr Richard Vautrey said it was possible for the government to significantly reduce bureaucracy and box ticking in next year’s contract but that a long-term programme of investment in general practice was also needed.

Viewpoint: BMA deputy chairman Dr Kailash Chand

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