Payments to GPs under the Quality and Outcomes Framework (QoF) of the new GMS contract look certain to massively exceed the original sums budgeted by the Department of Health.
Dr Ian Trimble, a Nottingham GP, advisor to the Department of Health and one of the architects of QoF performance management framework for general practice, said at last week’s PRIMIS conference in Nottingham that "practices are reaching 1000 point QoF scores against the original expectation of 750."
This huge over-performance means that GPs will earn far more than had originally been budgeted by the DH, he said. "In Trent region alone over-performance against QoF is about £10 million. Nationally the figure is probably in the order of £200 million."
"It will be interesting to see what the Treasury thinks about that," added Dr Trimble.
Dr Trimble said that in his view the QoF accounted for too much of GPs’ income this year: "The QoF should have formed less of a focus of GP incomes, it should also have been simpler."
He stressed, however, that the DH is now undertaking a huge review process on how QoF has worked in year one, and are currently "sifting submissions from across the whole of the DH empire", which are due in by the end of May.
But the timetable is extremely challenging if the submissions are to inform and shape a revised and improved QoF for next year: "The timescales are very tight if they are to be implemented by next April."
Despite QoF’s teething problems, Dr Trimble declared it a big success in its first year. He also stressed that practices and primary care organisations had worked extremely hard to achieve high QoF scores.
Because QoF critically relies on practice data, it has already resulted in a major improvement in data quality and accuracy and practice management. "One of the most profound effects of QoF is its impact on the professionalisation of practice managers," said Dr Trimble, who praised the invaluable help provided by PRIMIS facilitators in guiding practices on coding issues and exception reporting.
Dr Trimble added that the QMAS web tool had also proved invaluable in making it easy to see what practices are struggling, where they are struggling and then provide remedial help.