General practitioner General Practitioners Committee

Last updated:

QOF to end in ‘bold, overdue step’ welcomed by GPs

Chaand Nagpaul, special LMC conference
NAGPAUL: ‘We agree that QOF has reached the end of its useful lifespan’

The ‘box-ticking’ QOF (quality and outcomes framework) has ‘reached the end of its useful lifespan’ and will be phased out in new GP contracts.

NHS England chief executive Simon Stevens made the announcement at a conference in Birmingham on Wednesday – with plans under way to pilot alternative contract arrangements over the next 18 months.

The move has been welcomed by GP leaders who called for an end to the QOF in the BMA’s Urgent prescription for general practice earlier this year.

Speaking at the Best Practice conference, Mr Stevens said QOF had ‘delivered the gains it is going to produce’ and was becoming a box-ticking exercise.

‘We have to be thoughtful about how we do that, we can’t just go cold turkey on QOF from 1 April,’ he said adding that in the next 18 months NHS England would work with GP representatives to come up with an adequate successor.

The QOF was introduced in the GP contract negotiated in 2004 and links part of GPs’ pay to meeting quality indicators.


Must apply equally to practices

BMA GPs committee chair Chaand Nagpaul said: ‘We agree that QOF has reached the end of its useful lifespan.

‘This bold step, long overdue, will have a positive effect on practices by reducing bureaucracy and box-ticking, and allowing GPs to focus on the complex care needs of their patients.

‘It is important that the phased removal and end of QOF should apply equally to all practices, regardless of their contractual status, and must not be used as a lever for movement away from the current contract to a voluntary local contract. We believe that patients’ needs are best served under a national GP contract that provides nationally specified consistent standards of care.’

Mr Stevens told the conference that GP surgeries or federations looking after populations of more than 30,000 patients – and taking on the new voluntary GP contract – would be asked to pilot new ways of distributing the funding from QOF.

The voluntary contract was first announced by former prime minister David Cameron at the Conservative party conference in 2015. It was not negotiated with the BMA.


New care models

The voluntary contract is part of NHS England’s Five Year Forward View, which sets out a number of new models of care that NHS England believes represent ways to provide integrated care to patients, and which are being trialled at 50 ‘vanguard’ sites across England.

One new model comes in the form of multi-speciality community providers, which aim to integrate primary and community health services and are built upon the GP registered lists of the practices involved.

Individual practices working together, for example through a GP network organisation or a super-practice, will be able to create a combined patient list and bid for an MCP voluntary contract from their local commissioner.

The GP voluntary contract is due to be rolled out in April 2017, Mr Stevens said.

Read the BMA’s Urgent prescription for general practice

Find out more about the MCP voluntary contract 



Read more from Peter Blackburn and follow on Twitter.