Professor Martin Marshall told the Londonwide LMCs conference that it was ‘very unlikely that England will just abolish [the QOF] and leave a vacuum in the way that Scotland did.’
He said that ‘one of the discussions that is going on at the minute is whether we should shift QOF a bit’, which would involve reducing the number of indicators and using the remaining funding to pay practices to engage with quality improvement activities.
Professor Marshall said the QOF could become ‘a much smaller, much more focused set of indicators with a smaller amount of funding attached, and a larger amount of that money going into managing complex activities through quality improvement programmes.
‘So a practice in one year might start working on childhood obesity, working with a range of partners in a quality improvement programme, and get paid for doing that work.’ This work would not involve ‘tick-boxes’, he added.
‘That to me seems a much more sensible way of taking the system forward if GPs are willing to take the shake-up that would require – and that, I think, is a really big challenge,’ Professor Marshall said.
In 2016, the GPC and NHS Employers said that future contract talks would explore ending the QOF and it seemed likely that England would follow Scotland and abolish the framework. The following year, negotiations had moved towards 'examining the future of the QOF'. Any changes were expected to be introduced in April this year, but this deadline has been missed.
GPs in England could face a significant overhaul to their contract in 2019/20. Along with the QOF, the funding formula, partnership model and GP premises are also currently being reviewed by the BMA, Department of Health and Social Care and NHS England.
A final decision about how the QOF could change will be subject to contract negotiations between the BMA and the government.
Scotland scrapped the QOF in April 2016 and the associated funding was transferred into core pay. This year the QOF in Wales was stripped back to disease registers only, apart from flu targets which remain in place.