GPs voice fears over commissioning outcomes framework

GPs raised concerns relating to the impending introduction of the commissioning outcomes framework (COF) at a NICE 'information-giving session' yesterday.

Dr Gillian Leng: COF is still evolving (photo: Pete Hill)
Dr Gillian Leng: COF is still evolving (photo: Pete Hill)
NICE deputy chief executive Dr Gillian Leng and Nick Baillie, associate director of quality standards and indicators, outlined how the COF initiative had progressed and what it would involve initially. Dr Leng said: ‘It’s fair to say that it’s still an evolving piece of work.’

The final decision on which indicators will be set for CCGs in England will probably be made by the NHS Commissioning Board in December.

NICE is looking at including 10 indicators per topic, and some indicators may be incentivised. Among the topics chosen for the initial phase of introduction are cancer, mental health, respiratory care, and children.

Most delegates said they knew little about the COF and the panel discussion raised concerns about potential ‘gaming’ of indicators.

South London GP Dr Martin Marshall said that in quantitative terms gaming in the QOF had not been that big a problem, but he added: ‘But the impact on the credibility of the system is enormous, so it really needs to be managed. There are clever people gaming indicators.’

Stockton-on-Tees GP Dr Paul Williams said: ‘It’s telling us what is going to be measured but not who it’s going to be measured on.’

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