Many clinical commissioning groups were given control over their primary care budgets in April, under delegated commissioning arrangements from NHS England. This includes the power to replace the national quality and outcomes framework for GPs with a local designed incentive scheme but, according to the Health Service Journal, none of the 63 CCGs with this power intend to use it any time soon.
This is despite Health Secretary, Jeremy Hunt, criticising the current QOF framework as recently as last week. He said: “The quality and outcomes framework was meant to provide a better focus on outcomes, but has too often ended up as a tick-box process.” While none of the CCGs plan to implement a change in 2015/16, there are some groups that are in the early stages of implementing changes.
Three – Dudley, Greater Preston, and Chorley and South Ribble – plan to introduce one in 2016-17. Leiceister CCG said it was “looking at options” for a local framework next year, while others, such as Fylde and Wyre CCG, are “considering changes.”
Richard Vautrey, deputy chair of the BMA’s GP committee, said: “They’re hopefully listening to their [member practices] that will be telling them what they don’t want to do is to replace one quality system with something that is potentially more onerous and burdensome… You would end up with a postcode lottery of care, and a patient with diabetes, heart disease or lung disease wouldn’t be certain if they move from one area to another that they would get the comparable level of care.”
At the recent NHS Confederation Conference, NHS Clinical Commissioners co-chair, Amanda Doyle, said: “There was a bit of nervousness that the evidence supporting local [incentive schemes] isn’t particularly robust. The QOF is a pot of money that can be used to incentivise different behaviours and different ways of providing services. There is no point just replacing one set of indicators with another, with no better evidence.”