QoF changed to secure GP pay deal

GPs are to get no uplift in net pay for 2011-12, but there will be a rise in Quality and Outcome Framework payments to cover pay rises for lower paid staff.

The new deal signed off by the Department of Health and the BMA’s General Practitioner Committee at the end of last week means QoF payments will rise by 2.53% from £127.29 to £130.51.

The money is intended to be used by GPs to give pay rises of £250 to staff who earn less than £21,000 a year.

A total of 116.5 QoF points will be scrapped from the framework, releasing £130m, with most of the money used to fund a new Improving Quality and Productivity in the NHS scheme.

This will be designed to reward GPs for analysing their data on prescribing, first outpatient referrals and emergency admissions, and addressing any outlier performance.

The significant changes to QoF are based on recommendations made by the National Institute for Health and Clinical Excellence and the outcome of discussions between NHS Employers and the GPC.

Indicators to go include QoF payments for the GP Patient Survey plus those for recording blood pressure in patients with heart disease and diabetes and rewards for recording the ethnic origin of newly registered patients.

NHS Employers negotiator Stephen Golledge said the agreement would deliver immediate efficiency savings of 4%, with the promise of more to come.

He added: “If the new Improving Quality and Productivity in the NHS scheme takes hold in the way we hope, our calculations suggest that – if all practices can mirror the same level of performance as the top 25% of practices in the way they refer to consultants, manage emergency admissions and prescribe – this would generate further savings of up to £800m a year.”

Dr Laurence Buckman, chair of the BMA’s GP committee, said: “Given the state of the public finances, GPs, like other doctors, were not expecting a pay rise.

"But we are pleased that the government has recognised the need to increase practice expenses so that GPs can honour the commitment made to our lower paid staff.”

The deal also sees the extended access scheme in England extended for one year but with payments reduced from £3.01 to £1.90 per patient.

The two sides have also agreed to extend three clinical directed enhanced services covering support to overcome harmful drinking, health checks for people with learning disabilities, and osteoporosis diagnosis and prevention.

The package of changes has been agreed by NHS Employers on behalf of the health departments in England Scotland and Wales, but the Northern Ireland Assembly Government has yet to sign up to the deal.

Dr Buckman said: ““We are extremely unhappy at the failure of the Northern Ireland Assembly Government to sign up to this deal on time. We have a four-nation contract and it is not fair to Northern Ireland GPs or their patients to leave them in this situation.

“We expect the Northern Ireland Assembly to sign up to the changes that have been negotiated on their behalf by the NHS Employers Organisation as soon as is practically possible.

“There have been a number of significant changes to the Quality and Outcomes Framework which will make it difficult for Northern Ireland GPs to continue with the 2009/2010 contract and patients uncertain about what services they can expect from their practices after 1 April.”

Link: Full details of the changes to the GMS contract for 2011-12