MPs call for overhaul of quality framework

The Department of Health should revamp the Quality and Outcomes Framework (QoF) to give more weight to health outcomes and less to activity, MPs have said.

The House of Commons’ Public Accounts Committee report on the new GP contract  found that GP productivity has decreased annually by an average of 2.5% since the introduction of the contract in 2004 while the income of GP partners has increased by an average of 58%.

However it also reported that the contract has led to an increase of 15.3% in the number of GPs working in primary care, exceeding the government’s own target. It said the government had realised some but not all of the benefits from the new contract.

On the QoF MPs said the framework had increased the consistency of care of patients with long term conditions but claimed it largely concentrated on indicators that were easy to measure and as a result reflected GP workload more than improvements in population health.

The committee has recommended that the DH develop the framework so it is better aligned to health priorities, gives more weight to achieving health outcomes rather than clinical practices and allowing PCTs greater discretion on indicators to reflect local priorities.

However the BMA’s General Practitioner Committee claimed much of the criticism in the report was out-of-date.

Dr Laurence Buckman, chairman of the GPC, said hitting the QoF targets had been good for patient care.

He added: “QOF was a radical change brought in to improve health over the long-term. It was never just about measuring what GPs do. It means patients across the country get the same high-quality care wherever they are as all GPs follow the same evidence-based path. Furthermore, the gap between those in the most and least deprived areas is narrowing year on year.”

The BMA also challenged the suggestion that GP productivity has decreased Dr Buckman said.

He added: “The measure of productivity quoted is crude and doesn’t accurately reflect how GPs’ work has changed in recent years. GPs now deal with more complex consultations and the intensity of the work has greatly increased.”

Links

The House of Commons’ Public Accounts Committee report on the new GP contract

Related documents

NHS Pay Modernisation: New contracts for General Practice services in England