GPC fears over plan to divert £700m QOF cash to admissions and access targets

GPs leaders are raising concerns with NHS England after it suggested practices may have to meet new requirements on access and admissions to keep QOF money when the scheme is replaced.

GPC deputy chair Dr Richard Vautrey
GPC deputy chair Dr Richard Vautrey

Last week’s Next Steps on the Five Year Forward View report confirmed NHS England’s intention to replace the QOF.

But the document revealed that £700m in funding currently received by practices through the scheme could in future be spent on ‘improved patient access, professionally-led quality improvement, greater population health management, and patients’ supported self-management, to reduce avoidable demand in secondary care’.

GPC leaders fear the proposals, which had not been discussed with them before being published last Friday, could mean practices having to do more work to earn back the significant and vital funding.

QOF funding

NHS England officials and GPC leaders have been inching towards agreement on eventually replacing the QOF over recent years. NHS England chief executive Simon Stevens has said the pay-for-performance scheme, launched in 2004, had reached the end of its useful life, and the GP Forward View published in April 2016 promised a review on possibly replacing it ‘in the coming year’.

But in negotiations for the current contract both sides agreed to set up a working group immediately to discuss the scheme’s future beyond April 2018.

In its Urgent Prescription for General Practice policy document the GPC has called for QOF to be scrapped and the funding added, unweighted, into core funding.

GPC deputy chair Dr Richard Vautrey said practices would be ‘alarmed’ at the ‘unhelpful’ suggestion that funding on which practices depend could be used for reducing hospital admissions or improving access.

GP contract

‘We have just got rid of the avoiding unplanned admissions DES, the last thing we want is a replacement for that using QOF funding,' he told GPonline. 'And we have had access targets in QOF in the past which singularly failed.

‘We don't want to repeat the mistakes of the past with politically motivated initiatives imposed on general practice utilising existing resource,' he added. ‘If there is new work to do, that will require new funding, not recycling old funding.’

The GPC is raising its concerns over the announcement with NHS England, said Dr Vautrey. ‘It is not something that has been discussed with us, there has been no discussion at all about any future changes to QOF or replacement of QOF, or clarity about what work will stop in practices in order that they could do something different,' he said.

‘What we can't accept is additional work for practices to retain or get back some of that [QOF] funding which is essential funding for them, because the ongoing work of running a practice and delivering good quality long-term conditions management won't change whether QOF is there or not.’

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