09.04.14
Danger of replacing QoF with ‘an even more bureaucratic process’
Rules and restrictions for commissioners and GPs should be reduced if we want to bring back personal doctoring, Dr Michael Dixon, chair of the NHS Alliance, has said.
In a speech to clinical commissioning groups (CCGs) in Kent yesterday, he added that the ‘tick-box medicine’ or ‘medicine by numbers’ is not patient-centred medicine.
“We must free clinical commissioning from rules, regulations, competition restrictions and conflict of interest issues so commissioners and their constituent practices can plan and implement general practice at scale,” said Dr Dixon.
He hopes that by doing this it will allow GPs to take on the ‘out of hospitals services’ agenda that the health sector has been talking about for so long.
Dr Dixon, who sits on NHE’s editorial board, added: “Unfortunately, the good of all this is in danger of being ‘lost in translation’. The recently published DES on avoiding hospital admissions for the over-75s seems to be all about filling in forms, rather than relating and talking to our vulnerable elderly.
“When it comes to personal care and continuity it is often the un-measurables that are the most important things. And, having got rid of 40% of the quality of outcomes framework (QoF) because it was over bureaucratic, we are in danger of replacing it with an even more bureaucratic process in the name of something that is entirely appropriate and laudable.
“Consequently, in the same way as we must give clinical commissioners greater headroom to do what is right, we must also give frontline GPs and general practices greater headroom to make a real difference.”
He concluded by stating that the only way to make all this happen is by reducing rules and restrictions, not adding more. It also means handing more decision making powers to local CCGs working with local offices, who know the realities of everyday general practice, and the detrimental and demoralising effect that stifling bureaucracy can have on GPs trying to do their best for patients.
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