Agreement to suspend the Quality and Outcomes Framework because of the impact of swine flu cases looks likely to be left to individual primary care organisations (PCOs).

The General Practitioner Committee has told GPs that it is urgently exploring the possibility of individual PCOs suspending elements of the GP contract, which is controlled by strategic health authorities and supervised nationally.

In a letter to GPs, Dr Laurence Buckman, chairman of the GPC, said the original agreement on income protection in cases of emergencies envisaged that the decision would be triggered on a countrywide basis.

The letter adds: “However, the pandemic has not developed as evenly through the country as expected.

"In our discussions with the health departments and NHS Employers, we are exploring urgently the possibility of suspending elements of the contract on a PCO by PCO basis.”

Dr Buckman said the GPC was working closely with health departments and NHSE to finalise the arrangements for deciding when and how a revised Statement of Fees and Entitlements should be introduced. This would suspend normal working and enable income protection to come into effect.

The original agreement with NHS Employers covers the global sum, Quality and Outcomes Framework and directed enhanced services and means that practices will continue to be credited with the same level of achievement and income as the previous year.

Dr Buckman’s letter on the contractual implications adds: “I am sure you can see that such arrangements are necessarily complex and designed to be fair to practices and deliverable by the NHS.

"We have a definite understanding that GPs will not lose income as a result of working with the local NHS during a pandemic.”

Dr Buckman said the swine flu outbreak was already creating additional work for GPs and their staff and considerable additional work in the flu hot spots, particularly Birmingham, London and Glasgow.

He added: “GPs response to this challenge has been admirable, demonstrating all that is good about general practice, as GPs strive to do their utmost for their patients.”

Dr Buckman said updated joint guidance on pandemic flu from the BMA, the Royal College of GPs and the DH would be published shortly.