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LMCs say QOF is not ‘unfit for purpose’, at annual conference


26 May 2015

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Family doctors want to retain the quality and outcomes framework in the GP contract as they voted it not ‘unfit for purpose’, at the annual BMA LMC conference.

Dr Julie-Anne Birch, Cleveland Local Medical Committee (LMC), proposed the motion and said: “We are professionals and can be trusted, we don’t need to be measured all the time… Let’s get rid of the strait jacket of QOF.”

Family doctors want to retain the quality and outcomes framework in the GP contract as they voted it not ‘unfit for purpose’, at the annual BMA LMC conference.

Dr Julie-Anne Birch, Cleveland Local Medical Committee (LMC), proposed the motion and said: “We are professionals and can be trusted, we don’t need to be measured all the time… Let’s get rid of the strait jacket of QOF.”

However, before the vote Andrew Green from the General practice committee (GPC) said that he had “huge sympathy” that QOF does not reflect current concepts of patient choice, but warned that if the LMCs voted that it’s unfit for purpose they were opening the door for it being scrapped, which could mean large amounts of money would no longer given to high-performing practices.

The LMCs voted that QOF ‘does not recognise the increasing stratification of management of long term conditions dependent on the patients general health and co-morbidities’ and ‘does not reflect current concepts of patient choice.’ They voted against the idea that QOF is ‘unfit for purpose’ and ‘should be scrapped with the money transferred into the global sum.’

In response Gavin Jamie from QOF database said he agreed with doctors that QOF does not recognise the increasing stratification of management of long term conditions dependent on the patients general health and co-morbidities.

“In order for indicators to work at all they inevitably have to be quite simple, mostly coming down to a simple "yes or no" response. Things like blood pressure are seen largely in isolation without much context about the patient's circumstances. As patients are surviving for longer (and this a great success for medicine!) they can develop more long term conditions. Not all of these are recognised by QOF and so there is a tension.

“If it would be possible to produce a less reductionist set of QOF indicators that would be welcomed. I am interested that there was no vote on getting rid of QOF entirely. There have been alternatives proposed in specific CCG areas, most famously in Somerset. From what I have seen these seem to be fairly paper heavy themselves and it seems that conference did not find them very attractive either.”

 

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