Date Published: 13 January 2009

BMA response to consultation on the Quality and Outcomes Framework

Proposed changes to the Quality and Outcomes Framework (QOF) could lead to it being inappropriately influenced by political imperatives and to patients getting postcode healthcare in primary care, the BMA said today (Tuesday 13 January 2009) in its formal response to the government’s consultation on the QOF.

The Department of Health consultation, Developing the QOF: Proposals for a new, independent process, says that the QOF should be brought under the remit of the National Institute for Clinical Excellence (NICE) and that Primary Care Trusts should be able to select some indicators based on local need.

In its response the GPC say localising the QOF “will be seriously detrimental to the already reduced gap in health inequalities” which its introduction achieved and may threaten consistency of care. It stresses the importance of a UK-wide, evidence-based QOF to maintain its status as a world leader in primary care quality standards.

The response says:

“We do not believe that NICE is a body completely independent of government influence and do not feel that it would do a better job than the current independent expert group.” It warns “this would affect the profession’s and patients’ confidence in the QOF as well as risk undermining the professional relationship of GPs with their patients.”

It says the proposed pace of change is unrealistic and would threaten both delivery and quality and expresses concern that the decision regarding the involvement of NICE already appears to have been made. It suggests a moratorium on change is needed to allow adequate time for the negotiation of alterations to indicators.

Dr Laurence Buckman, Chairman of the BMA’s GP Committee, said:

“It is vital all LMCs respond to this consultation. Even though this is an English consultation the proposed changes will have an impact on QOF across the UK. As it stands the changes proposed in this consultation will create rather than get rid of health inequalities.”

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