'Political' QOF cuts to cost GPs £15,000

Practices face average losses of around £15,000 a year because of 'politically motivated' DH plans to impose the biggest-ever overhaul of the QOF.

GP leaders attacked plans set out by the DH after contract talks collapsed as 'fundamentally damaging' to the profession.

They warned the plans would slash £126m from the value of QOF, force practices to compete for points and deliver 'unworkable' targets.

Health secretary Jeremy Hunt told GP that the offer was fair for GPs and their patients.

Ministers announced their intentions for QOF after five months of negotiations with the GPC. More than half of all QOF points would be affected by the plans.

The DH wants to scrap all organisational targets apart from quality and productivity indicators, which are tied to the NHS efficiency savings drive. But practices would be expected to continue delivering 'retired' measures – including staff education and training, medicines management and record-keeping – for no pay.

Writing to the profession, GPC chairman Dr Laurence Buckman said: 'This not only forces GPs to take on swathes of unresourced new work, but also worryingly moves money from an evidence-based vehicle into schemes which are undeveloped, unnegotiated, politically driven government whims.'

QOF money freed up by this move would pay for new enhanced services for long-term conditions, dementia and online access to patient records.Ministers also want stricter thresholds to force practices to match the performance of the top 25% in previous years to gain maximum points.


KEY POINTS

DH plans for QOF

  • Organisational targets scrapped to fund new enhanced services
  • Target thresholds raised
  • Stricter rules on recording annual checks

The GPC estimates this could wipe £126m off the value of QOF – an average £15,000 from every practice per year.

The plans would also give practices 12 months to conduct annual checks worth a third of all QOF points, instead of the current 15 months.

All NICE's proposed changes to QOF would be accepted without negotiation. The GPC said this would lead to 'impractical' targets, including referring patients to services not available across the UK.

Mr Hunt said the GP contract 'needs to change. We've put a fair deal on the table which offers GPs more funding but in return, we want to see better care for patients.'

Expert view: The GP

QOF expert and Wiltshire GP Dr Gavin Jamie reacts to the changes

Stricter thresholds

'The plans are going to push up thresholds. This year's data have just been released, so practices will be able to work out what this upper quartile will be and what sort of jump to expect. But there will be a jump, which in the end means this is less money for doing the same work.'

Tougher annual check limits

'Oddly enough, practices will have to become stricter with patients when they book their reviews, because they don't want them to be either side (of the 12-month time limit).

'If the reviews are due to be done in April, we'll want to stop them making an appointment in March. It'll be much more of an advantage to carry out these reviews mid-year. This will mean less flexibility for patients.'

Funding for QOF moved to enhanced services

'QOF money is tied into the GP contract, but enhanced services are much easier to pass on to another, private provider.

'There's also the suggestion from the NHS Commissioning Board that it is looking at enhanced services being much more contested between GPs and other providers.'

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