QoF reform in five year plan

The Department of Health has promised to introduce a “significant reform” of the Quality and Outcomes Framework from 2011 as part of its five year plan for the NHS.

Launching its strategy, NHS 2010-2015: from good to great, health secretary Andy Burnham said it was time to accelerate the pace of NHS reform to make systems more productive and improve the quality of care.

Among the package of measures outlined in the strategy are plans to make better use of assistive technology for patients with long term conditions, to cut primary care trust and strategic health authority management costs by 30%, to expand NHS Choices, pay hospitals according to patient feedback and give hospitals more freedom to provide GP services.

Burnham said: “The challenge to the NHS, and to NHS leaders and staff around the country, is to reshape services further and faster than ever before.”

On the QoF, the DH said it exceptionally agreed "to make no changes to the quality scheme in 2010-11 because of pressures from pandemic flu" but that from 2011-12 onwards there would significant reform to to deliver improvements in quality and efficiency.

The plan says QoF reform is likely to mean raising performance thresholds and retiring indicators that have limited cost-effectiveness “to make way for more stretching quality indicators”.

The strategy says the NHS will make more used of information-based technologies to design new models of care as well as improving the performance of existing services.

It adds: “We will integrate information around the patient, deliver relevant information at the right time to clinicians and use technology to drive efficiency for both patients and clinicians.”

A key focus of the strategy is to support the move from hospital to community care and the plan says that in the next few months the NHS will create programmes to consider what high-impact changes could be made including making the best use of assistive technology.

Burnham added: “Quality care is not always about spending more money but about spending it in the right places. Moving care from hospitals into homes and communities is better for patients and more efficient.”

On NHS Choices, the strategy says the information available on the DH’s flagship website will be expanded and that the use of international benchmarks will be explored.

It says the DH will extend its partnership with the parenting site Mumsnet to allow users to supply feedback on the maternity care they have received and that it will also pilot arrangements to enable parents to give feedback by text message.

Other elements include linking hospital payments to patient satisfaction, rising to 10% of payments over time, abolishing GP practice boundaries, and giving hospitals more freedom to expand their services into the community across a wider area including GP centres.

Dr Hamish Meldrum, BMA Council chairman, said the BMA welcomed the government’s commitment to maintaining NHS funding in England and to protecting frontline services but said the scale of the challenge in carrying out many of the plans in the document should not be underestimated.

“Redeploying budgets and staff, or reconfiguring services, is never straightforward,” he added.

Link: NHS 2010-2015: from good to great. Preventative, people-centred, productive.