Quality premium must be scrapped, says GPC

GP leaders have urged the DH to scrap plans to pay a 'quality premium' to successful commissioners, citing warnings in the Francis report about the target-driven, bullying culture behind failings in Mid Staffordshire.

Dr Richard Vautrey: quality premium could lead to bullying
Dr Richard Vautrey: quality premium could lead to bullying

GPC deputy chairman Dr Richard Vautrey said the controversial quality premium could lead to CCGs bullying practices to ensure they did not miss out on funding worth up to £11,250 per average practice.

Dr Vautrey said: ‘It is when the systems are wrong that the problems occur. That is the key lesson from the Francis inquiry.

'The key thing is CCGs shouldn’t budget to assume they are going to get it. The quality premium will allow them to set local aims which may be wholly appropriate for that CCG.

‘They should do it because it is a good thing to do. If it is good to try to improve services in their area, they should as professionals try their best to actually do that and I don’t think anyone would argue against that. The difference is not linking the assumption that by doing that you will get some pot of gold at the end because I think it is going to be difficult for many CCGs to do that.'

GPC chairman Dr Laurence Buckman said that managers on CCGs should not impose targets and performance manage practices to meet those targets if it risks damaging patient care.

He said: ‘They want to remember their professions first and the professional thing is you don’t bully. We know that is happening - don’t stick to a financial target if it means damaging patients.’

GPC negotiator Dr Chand Nagpaul said: ‘CCGs will be operating within a rigorous performance managed framework filled with targets and financial performance management targets. We are very worried that CCGs should be subject to the very dynamics and forces that were identified as being damaging in the Francis report. In particular CCGs will need to ensure financial balance and if they don’t, they will be denied funding through the quality premium. We want to see a removal of the target culture in CCGs.’

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