In a letter to practices dated 9 July, NHS England said that it recognised that practices would need to 'reprioritise aspects of care not related to COVID-19' adding that it planned to 'modify the QOF requirements for 2020/21 to support this'. It said that the QOF would not be reintroduced fully until April 2021.
NHS England and the BMA are still in discussion about some of the exact changes that will be implemented for the framework this year. However the letter said that NHS England was proposing that practices would be 'asked to gear up for a major expansion of the winter flu programme', with further details expected in the 'coming weeks'.
Under the proposed QOF changes NHS England would expect practices to maintain accurate disease registers, prescribing indicators and deliver cervical screening indicators during 2020/21 and for achievement to be 'as close as possible to normal performance' in these areas.
Income protection measures
The quality improvement indicators for this year, which were set to focus on early cancer diagnosis and the care of people with a learning disability, will be amended so that they focus on restoring delivery of care in these areas rather than delivering improvement activities, the letter said. Payments for practices in this domain will be based on achieving the new requirements.
Income protection measures will be put in place for all other indicators, NHS England said. However, it added that this would be 'subject to the delivery of revised and simplified requirements focused upon care delivery to those patients at greatest risk of harm from COVID-19, uncontrolled long term condition parameters and those with a history of missing reviews.'
Further details on the changes to the QOF, including details of the income protection measures, are expected to be published shortly, NHS England said.
The NHS England letter also revealed that monthly payments for practices for the minor surgery DES and violent patients scheme DES from 1 April 2020 to 30 June 2020 will be based on last year's achievement, but there was no detail about any changes going forwards.
In terms of childhood immunisations practices will only be offered income protection for the final three months of 2019/20 and 1 April to 30 June 2020. To receive this they will 'need to demonstrate that they have submitted data through Open Exeter by the required dates, that their planned performance had been negatively impacted by COVID-19 related activities and that this had a material impact upon payment.'
NHS England suggested in May that this year's flu campaign could be extended to a wider group of people. Officials also asked practices in May to review their vaccine orders ahead of a likely surge in demand due to health fears sparked by the COVID-19 pandemic.
In recent weeks there has been speculation that the government intends to expand the campaign to cover all over-50s. The Labour Party has also called for this year's vaccination programme to be extended to everyone aged over 50 to protect the NHS from having to contend with a winter flu outbreak and a possible surge in COVID-19 at the same time.
Estimates suggest that if this was to happen up to an additional 10m vaccinations would have to be delivered as part of the campaign.