NHS Employers and GP representatives have agreed a revamp of the GMS contract which will see the value of the Quality and Outcomes Framework (QoF) decrease over time.
The QoF has also been overhauled to give more weight to outcomes with 72 points redistributed. The square root formula to calculate prevalence is also to be scrapped.
The overall uplift to the contract will still be agreed by the Review Body but the BMA’s General Practitioner Committee, NHS Employers and the four health departments have agreed the uplift will not be applied across the board.
Instead the pay increase will be applied to the global sum, QoF, enhanced services and the correction factor in the ratio 7: 5:5: 2. The GPC and NHS Employers said the overall purpose of the methodology was to reduce GP reliance on correction factor payments.
The changes to the QoF mean that payments for the GP Patient Survey will be removed and some other existing indicators will be worth slightly less while new indicators are introduced for clinical areas including heart failure, chronic kidney disease, contraception, depression and diabetes.
The package of changes to the QoF will apply for 2009/10 and the negotiating team has agreed that that all the new indicators will be reviewed before the start of 2011/12 in the light of changing priorities for health and healthcare.
The GPC and NHS Employers have also agreed changes to the way prevalence is calculated when making QoF payments. On 1 April 2009 the square rooting formula will be discontinued and on 1 April 2010 true prevalence will be used to determine
QoF payments, bringing to an end the current cut off arrangements.
The two sides said the overall effect of the prevalence changes would be broadly cash neutral but added that a small number of practices may experience a significant loss.
The Departments of Health in all four of the UK’s home countries are to issue guidance to PCOs to consider the impact on practices significantly affected by the changes and to consider whether new services need to be commissioned to meet local health needs.
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