NICE said more clarity was needed on how the NHS Commissioning Board and consortia will manage individual practice’s performance.
Where providers serve patients covered by more than one consortium, ‘it may be difficult to determine whose commissioning is producing changes in a GP consortium’s outcomes,’ it said.
The response suggests the quality premium must be ‘carefully phased in and evaluated’ using pilots. NICE also said criteria are needed to calculate how to share the quality premium among practices.
It added that ‘more clarity is needed on the roles of consortia and the NHS Commissioning Board in managing the performance of individual GP practices’.
‘Rigour applied by NICE to reviewing and developing QOF indicators would need to be applied to methods for measuring performance for purposes of the quality premium,’ the response said.
NICE says that the care pathways defined in the quality standards should be resource neutral, by balancing quality with economy and focusing on clinical- and cost-effectiveness.
It also suggests that generic statements on patient experience and patient safety could be included in each of the quality standards.
NICE says it is concerned about the potential problems if the populations covered by GP consortia do not match those of local authorities.