Leeds QOF suspension blocked as NHS officials say it was 'never formally sanctioned'

CCG leaders have said that they sought permission from NHS England to suspend the QOF for practices in Leeds before NHS England chief executive Simon Stevens intervened to tear up the deal.

GPs in the city are angry a deal to ease pressure on practices struck between the LMC and three Leeds CCGs has been scrapped after Mr Stevens said last Thursday it was not legal.

CCG leaders believed the deal to help practices cope with heavy workloads following problems with a local pathology service had been approved by local NHS England officials before the body’s national leadership stepped in. NHS England has said the plan was never formally sanctioned.

In a letter sent to practices this week, seen by GPonline, the CCGs said they had taken advice and sought permission before agreeing the deal to allow practices to opt out of up to 80% of QOF targets for the rest of the year with no financial losses.

GP crisis

The CCGs said they would continue to explore with NHS England legal mechanisms to support practices which face QOF losses because of outside pressures.

GP leaders welcomed the deal when it was announced earlier this month as an ‘encouraging step forward’ that allowed practices to focus on patient care.

Practices in Leeds have been coping with the additional pressures caused by the failure of the pathology results service last year and the LMC had been lobbying commissioners to relax QOF targets to free up practice capacity. CCGs wanted the flexibility to reduce time spent on bureaucracy.

Health service and GP leaders in Wales and Northern Ireland have agreed similar deals to suspend the QOF for the rest of this financial year due to pressues on practices. The 2017/18 GP contract deal revealed that a working group is due to begin work on looking at the future of QOF post-April 2018 shortly.

Mr Stevens told NHS England’s board meeting last week that ‘legal advice’ was clear that  it ‘would not be possible’ for CCGs to change QOF elements of the national contract. He said ‘a lot of practices' had told NHS England it would be unfair 10 months into the year to mess around with QOF payments.

QOF workload

GP leaders reacted with surprise to Mr Stevens’ intervention given a previous deal allowing Somerset CCG to suspend the QOF to ease pressure on practices.

Leeds CCGs told practices this week: ‘Despite taking advice and seeking permission, we have now been advised that we do not have the legal powers to amend the QOF payments to practices and that we must continue with the national approach to the quality framework.’

Practices in the city were told to continue to with QOF work for the rest of the year. ‘We are disappointed that we have been unable to authorise flexibility in-year to the national QOF payment arrangements,' the letter said.

It added: ‘We remain committed to establishing a legal approach to support practices that are unable to achieve historic QOF payments due to no fault of their own actions. We will therefore continue to explore with NHS England how this can be achieved and will then further communicate with practices after those discussions and with the LMC.’

GPC deputy chair and Leeds LMC assistant medical secretary Dr Richard Vautrey said: ‘The CCGs in Leeds have told practices that NHS England will not allow them to suspend QOF. However [NHS England] has not provided any clear reasons for this decision.

'This has left practices angry at the double standards NHS England seems to have adopted with regards to support for hospitals on the one hand and general practice on the other and bemused why NHS England don't feel able to provide the support to practices that administrations in Wales and Northern Ireland have been able to do.’

A spokesman for NHS England said it had 'never formally sanctioned this approach'.

He said: ‘Having talked to a number of GP practices, it’s clear they are concerned that messing with QOF this late in the year would be unfair - especially given the work they have put into it over the past 10 months - nor would it be likely to do very much practically to help practices or hospitals over the next eight weeks.'

NHS England was unable to provide details on why it had decided the deal was not possible.

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