NHS reforms

03.02.17

BMA calls for national suspension of QOF to reduce ‘bureaucratic burden’ on GPs

The BMA has formally asked NHS England for a nationwide suspension of the quality and outcomes framework (QOF) to allow GPs to focus on patient care.

The chair of the BMA’s GP committee (GPC), Dr Chaand Nagpaul, has written to the national body saying that such a move would relieve GPs who are facing gruelling workloads this winter.

The BMA’s call follows in the footsteps of a recent initiative secured by BMA Cymru Wales in which the Welsh government agreed to suspend 75% of the QOF to give GPs more time to care for patients, while Northern Ireland has also suspended the framework.

“There is absolutely no doubt that practices in England are under significant workload pressures,” Dr Nagpaul wrote to NHS England’s director of NHS commissioning, Ros Roughton, in a letter dated 25 January. “At such a time as this it is imperative that NHS England does all it can to relieve this pressure so that practices can prioritise the care of urgent cases and provide support to the most vulnerable.

“Whilst practices will already have done most of the work to achieve QOF indicators this year, removing the requirement to achieve these targets will reduce unnecessary bureaucratic burdens and send an important signal of support to GPs in England at this challenging time.”

The QOF, a voluntary programme which financially incentivises practices to meet 559 quality of care indicators, is a point of contention for English GPs as many see it as a bureaucratic burden, noting that the framework has already been abolished in Scotland.

Despite the BMA’s formal request to NHS England, some local commissioners are already looking to bend the rules following NHS Wales’ decision as three Leeds CCGs permitted GPs to opt-out of up to 80% of the QOF earlier this week.

All GP practices in the city have been informed of the two-month suspension, which will apply to most of the 559 ‘clinical points’ except those concerning flu targets, cancer and the maintenance of disease registers.

“We hope that this flexibility will go some way to recognise the pressure general practice is facing and reduce the time spent on end-of-year bureaucracy,” read the CCGs’ letter to the practices, which was also supported by the local medical committee (LMC).

It is understood that other LMCs are writing to CCGs to push for similar deals while NHS England stalls on declaring a national suspension of the QOF.

The BMA GPC’s deputy chair and assistant medical secretary on Leeds LMC, Richard Vautrey, called the Leeds decision an “encouraging step forward”, as he noted a growing understanding that GPs are under winter pressures as much as A&E departments.

Vautrey confirmed that the BMA has called on NHS England to follow Wales and Northern Ireland in suspending the QOF while also putting pressure on central government to give GP services “badly” needed additional funding.

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