In a Pulse article last week some GPs in the South West of England were told to stop doing Quality & Outcomes Framework (QOF) and focus on other local priorities. This was apparently after CCG leaders struck a radical agreement with NHS England to ‘switch off’ reporting their achievement for the rest of the financial year and instead have been encouraged to participate in a CCG-wide project to ‘redesign GP services’ before April 2014 and make an early start on the unplanned admissions directed enhanced service (DES).
Tick box exercise
Of course, providing good quality clinical care would mean that many of the actions under QOF will continue, but practices have been told to do this in a way that is ‘more focussed on patient’s needs.’ Isn’t this what should have been happening anyway? Although, sadly, QOF has turned into a time consuming tick box exercise.
Support from NHS England
NHS England has backed local area teams in allowing some GP practices to ditch QOF for the rest of this financial year, saying that it was an example of an ‘innovative solution to commissioning primary care.’ However this directive has caused some alarm at the GPC who feel that NHS England should not simply ‘suspend’ on a national basis the QOF indicators that are scheduled to be retired ahead of April 2014.
Time to think outside the box?
It’s an insightful proposition but I wasn’t aware that area teams had a mandate to negotiate local agreements. GPs strive to do the best for their patients and my concern would be that these Practices accept an offer of a deal with stringent targets and end up worse off. I feel QOF has given a structured approach to patient care and it has continued to evolve since its introduction 10 years ago. I suppose that promises of comparable funding for other activities could be a smokescreen for longer term cost reductions but maybe it is time now to think outside the box and be revolutionary. After all, the NHS is no longer the creature it used to be and tough new reforms make things more and more difficult for Practices, especially innovative ways to increase income.
QOF has set the foundations for the achievement of CQC outcomes. My advice would be to check local contractual agreements to ensure patient care isn’t going to be compromised by even tougher payment by results schemes and use the QCS Management System to continue to meet CQC outcomes.