Consultation On GP Quality Incentive Scheme Launched, UK

Main Category: Primary Care / General Practice
Article Date: 30 Oct 2008 - 5:00 PDT

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Delivering the best possible care for patients and addressing health inequalities will be at the heart of proposed changes to the GP quality incentive scheme, the Quality and Outcomes Framework (QOF), Health Minister Ben Bradshaw announced today.

The QOF rewards GP practices for managing some of the most common chronic diseases such as diabetes or heart failure; improving health; organising practices well; how patients view their experience at the surgery and the quality of extra services offered such as child health and maternity services.

Under new proposals set out in a public consultation published today, the National Institute for Health and Clinical Excellence (NICE) would in future oversee the annual process of reviewing clinical indicators. From April 2009, NICE would review the benefits to patients and the cost effectiveness of the indicators used to assess the quality of care provided by GP practices. NICE would be responsible for developing a more transparent and inclusive review process with input from patients and carers, primary care professionals and other stakeholders.

The final choice of QOF indicators would remain a matter for negotiation with the British Medical Association (BMA), based on the advice produced by NICE.

The 12-week consultation is seeking views on how the new process for assessing evidence for QOF indicators should work.

The key elements that will be considered in the consultation will be how best to:

- Review existing QOF indicators and develop new indicators for clinical quality and health outcomes, based on evidence of clinical effectiveness;

- Allow a range of stakeholders, including patients, carers and clinicians to identify potential QOF priorities;

- Set up a panel of independent experts that will prioritise areas for developing new indicators;

- Pilot new indicators with GP practices; and

- Give flexibility to the local NHS to select some indicators to reflect local health needs.

Health Minister Ben Bradshaw said:

"We have come a long way in addressing health inequalities thanks to the current GP scheme for quality incentives and the UK leads the world in providing incentives to GPs to improve quality of care for patients.

"The latest figures for the Quality and Outcomes Framework show that practices have continued to deliver improvements in services for patients. But we want to ensure that GP practices continue to deliver more improvements to patient care, and the system needs to evolve to support practices in achieving even better outcomes for patients.

"Asking NICE to manage a more independent, open and transparent process for reviewing QOF indicators will make sure that we make the best use of our annual investment in the scheme and continue to support GPs in delivering the best care possible for patients, allowing the QOF to adapt and respond to the latest medical advances."

Professor Peter Littlejohns, Clinical and Public Health Director at NICE, said:

"NICE welcomes today's proposals for the reform of the Quality and Outcomes Framework (QOF). One of NICE's acknowledged key strengths is the robustness of its process for assessing what is both clinically effective and what represents best value for the NHS. By contributing to the process of developing and reviewing performance indicators for GPs, we can ensure that the principles behind our recommendations are reflected in the QOF."

Dr Mike Dixon, Chairman of the NHS Alliance said:

"The Quality and Outcomes Framework for the new GP contract has made UK GP practices the most accountable in the world. The new arrangements with NICE provide it with even greater credibility and, what's more, will make a real difference to the quality of care our patients receive.

"NICE provides a level of objectivity and authority that can only increase the validity of the quality framework, which has already been shown to improve quality of care and reduce inequalities."

A copy of the QOF consultation, including a full explanation of how the current scheme operates and details of how to become involved in the consultation can be downloaded from: www.dh.gov.uk/en/Consultations/index.htm

2. The consultation closes on 2nd February 2009.

Department of Health