Scotland to replace QOF with incentives for continuity of care and holistic approach

Scottish practices could soon receive extra payments for forming long-term relationships with patients and taking a holistic approach to care, proposals for a scheme to displace the nation's QOF suggest.

GPC Scotland chairman Dr Alan McDevitt: QOF replacement
GPC Scotland chairman Dr Alan McDevitt: QOF replacement

The proposed 'values-based quality' approach is expected to recognise – and financially reward – GPs for providing a range of measures, signifying a shift away from the current ‘payment for performance’ QOF scheme used in general practice.

The changes will better acknowledge that GPs’ contributions amount to ‘more than the sum of biomedical management of illness’, the Scottish government said, introducing the future scheme.

The Scottish GPC told GPonline that full details could not yet be revealed due to ‘ongoing negotiations’, but confirmed that the new arrangement will kick in with the new Scottish contract in April 2017, once agreements with the government have been finalised.

The scheme will offer an alternative payment scheme to the QOF, which is set to be phased out this April – one year ahead of the overhauled, three-year rolling contract.

Scottish QOF axed

As an interim arrangement for 2016/17, funding for the 659 points remaining in the Scottish QOF will be transferred to each practice’s global sum when it is dismantled on 1 April 2016. The amount paid will be based on a practice’s average achievement for those points over the last three years, including 2015/16.

Approximately 25% of the amount transferred to core funding – about £20m – will be designated to 'continuous quality improvement' funding, which will be used to maintain disease registers and patient coding that currently form part of the QOF.

Introducing plans for the new payment scheme, the Scottish government’s National Clinical Strategy report said: ‘It is anticipated that the negotiation of the new GMS contract for Scotland will see the development of recognition of, and payment for, "values-based quality".

‘This approach recognises that the contribution of general practice to individuals and communities is more than the sum of biomedical management of illness, and relates also to issues such as access, continuity, relationship forming over many years, and a holistic approach to all issues impacting on physical, mental and social health.’

In addition to the QOF’s demise, the 2017 Scottish contract is expected to oversee the creation of ‘GP clusters’, with GPs predominantly providing medical expertise and advice to patients with complex needs while an expanded team of other healthcare professionals take on routine services.

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