Target fears over QOF pay IT system expansion

GPs fear plans to broaden the remit of the IT system that calculates QOF pay will fuel the rise of a 'target-driven culture' in general practice.

The DoH and NHS Connecting for Health (CfH) are considering replacing the quality management and analysis system (QMAS) with a system that monitors beyond QOF.

The replacement tool would also monitor directed and local enhanced services, and other ‘local quality indicators'. These may include targets proposed by NICE for the QOF, but rejected by negotiators.

Dr Grant Ingrams, co-chairman of the joint GPC/ RCGP IT committee, said PCTs could use the data to performance manage practices.

 ‘The government is pushing towards the micromanagement of general practice and a target-driven culture,' he warned.

This would be to detriment of patient care, said Dr Ingrams.

‘If you introduce targets and make it really important that practices meet them, either for financial reward or because of the way it's portrayed in the press, then practices will put them above quality of care because that can't be counted,' he added.

NHS Alliance GMS contract lead Dr David Jenner said: ‘I worry about not knowing how the evidence might be used.  It could be used by the PCT for balanced scorecards or for an extra element of contract monitoring.'

Dr John Canning, chairman of the GPC contracts and performance subcommittee, said any new system would need to be ‘properly negotiated' because ‘as always, the devil will be in the detail'.

‘If this is something that will help practices achieve registration with the CQC and gain accreditation then it's good. But if it's a top-down dictatorial approach then it's unhelpful,' he said.

A DoH spokesman said a contract with QMAS supplier BT was ending soon and this had prompted the review.  CfH is surveying staff about QMAS until 9 November.

  • Read the full version of this story in this week's edition of GP dated 6 November

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