Shift QOF cash to fund core services in coronavirus pandemic, say GPs

QOF and enhanced services cash should be diverted to fund essential services in the event of a UK coronavirus pandemic, with appraisal and CQC inspections halted, LMC leaders have warned.

In a last-minute motion submitted for debate at a special conference of LMCs in London on 11 March, GP leaders said the threat of contract sanctions or breach notices should be lifted to ease pressure on practices forced to limit routine GP services during the coronavirus outbreak.

Funding must be made available too for any equipment or training practices require to manage the spread of COVID-19, the motion from Londonwide LMCs argued.

Speaking on the eve of the special conference, Londonwide LMCs chief executive Dr Michelle Drage warned: ‘Given the current situation with COVID-19, really we need time and space to look after our patients properly.

Coronavirus outbreak

‘If this becomes pandemic - probably it won't - and we're down to providing essential care, then all of our funding needs to be diverted into central care and all of our funding that comes through the contract needs to go into essential services. I hope you'll back us on that, I hope the rest of the country backs us on that.’

The special conference debate took place just hours after it emerged that health minister Nadine Dorries is among UK patients infected with coronavirus. Ms Dorries is the first MP diagnosed with the illness

The Mid Bedfordshire MP is understood to have attended a Downing Street reception also attended by prime minister Boris Johnson within the past week. She is one of 373 confirmed UK cases in total, with six patients infected with COVID-19 confirmed to have died as of 10 March.

Speaking at the conference, BMA GP committee deputy chair Dr Mark Sanford-Wood urged LMCs to back the Londonwide motion. He said GP leaders were in daily talks with NHS England and Public Health England over possible measures to ease pressure on GPs - including suspension of QOF, CQC checks, supplies of personal protective equipment (PPE) and rapid testing of frontline doctors.

GP workload

GPs called earlier this week for the suspension of routine appointments. Three quarters of respondents to a GPonline poll of more than 400 GPs backed the move, with one in five calling for the suspension to take effect immediately.

The special conference - just the third LMC gathering of its kind this millennium - was convened after the BMA's GP committee rejected a package of contract proposals in January including a version of the controversial network DES put out for consultation over Christmas and the New Year.

The committee later backed a revised contract package after major concessions on the DES that reduced work required from primary care networks (PCNs) from April 2020. Despite the overhaul, many GPs remain deeply concerned about plans for PCNs under the 2020 contract - and the conference is set to debate calls for a boycott of the DES.

Debates over the day-to-day operation of routine GP services could be overshadowed by rising concern over coronavirus, however. RCGP chair Professor Martin Marshall today warned that coronavirus could be the 'biggest issue the NHS has even seen' and criticised the government for failing to prioritise general practice in its preparations.

GPonline's latest opinion poll found that two thirds of GPs did not feel their practice was adequately prepared to deal with the emerging outbreak, while more than half of GPs (53%) said practices had not received adequate guidance and information about COVID-19. 

Read the Londonwide LMCs motion in full:

That conference is concerned that if the potential pandemic of Covid 19 occurs, practices will be required to suspend normal practice to cope with the increased workload and the potential decrease to the workforce and in such a scenario they require GPC England to urgently negotiate that:

  • all contract payments including DES and QOF payments will be paid in full but utilised to fund essential services only.
  • no contractual sanctions or remedial/breach notices will be issued to practices as a result of the forced changes to normal practice whilst the national emergency persists.
  • any additional costs relating to infection control for Covid 19 infections in general practice including personal protection equipment and additional training will be readily available in sufficient quantities and directly reimbursed.
  • practices are able to prioritise frontline work and suspend other requirements including appraisals and CQC inspections.

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