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QOF changes to see up to a quarter of indicators retired

A quarter of QOF indicators could be cut under new proposals drawn up by NHS England following a review of the framework.

The indicators that are to be scrapped will be discussed following an ‘engagement exercise’ with GPs and other stakeholders, launching today.

A full retirement of QOF was considered, as is the case in Scotland, but NHS England decided to follow a ‘moderate’ approach to retirement, with only some indicators removed.

The consultation comes after a review of the framework involving representatives from the BMA’s GP Committee, RCGP, NICE, Public Health England, Department of Health and NHS England.

Despite fewer indicators, NHS England said the proportion of practice income that QOF contributes will remain the same.

Instead, practices will be able to choose from a list of ‘quality indicators’ that will be agreed nationally and locally.

In addition, the proposals suggest that between a third and a half of the indicators will be updated to reflect NICE guidance.

The report also discusses a ‘rebranding’ of exception reporting, to be called the ‘personalised care adjustment’ for indicators, which will allow nurses and GPs in primary care to make a clinical judgement over whether a patient needs to – for example – have their blood pressure checked if other attributes of the patient suggest otherwise.

Meanwhile, the report also proposes meeting QOF targets as a network of practices, which NHS England has said will be trialled first.

Following the engagement exercise, the feedback will be discussed with the General Practice Committee (GPC) during the contract negotiations for next year. 

NHS England said the earliest changes to the QOF will be implemented is April 2019, when the new contract comes into effect.

However, it added that some changes may take an extra year to put in place.

Ian Dodge, NHS England’s national director for strategy and innovation said: ‘2019 starts the most substantial discussion of the GP contract since 2004 - given the forthcoming long term NHS plan, current pressures on general practice, the emergence of primary care networks, QOF and indemnity reform, the partnership and premises reviews.

‘This calls for more intensive joint working between NHS England and our partners, particularly the BMA, and I look forward to constructive and fruitful discussions with Richard [Vautrey – chair of the GPC] and his team.’