Already I have started to look at which enhanced services and QOF targets are a net cost to the practice. At some stage these will have to be handed back to the PCT to find an alternative provider. I suspect it will have great difficulty finding one for what it is offering.
QOF needs to be a long-term strategy and, like any investment, benefit will be in the future.
The Payments by Results cost of one patient reviewed at a hospital follow-up appointment is two to three times what a practice gets paid to look after a patient for one year.
I have asked several sources, including my PCT and the GPC, for a comparison of value for money between GMS and APMS contracts done on a weighted capitation (i.e. an even playing field) and no one has been able to provide this.
If GPs were all employed, or salaried, most would have to significantly reduce their working hours to meet the 48-hour working time directive.
General practice provides fantastic value for money. We are open for business and ready to take on new work if resourced. Growing commissioning and funding services when appropriate in general practice is the only way to avert a huge crisis in NHS funding and would be very popular with patients.
Dr Ron White, East Sussex