General practices will have to work around QOF if they are to implement a long-term condition (LTC) patient self-care approach, it has been claimed.
The ‘care planning’ model moves away from the practice of defining a patient by their LTC and seeks to strengthen the relationship between a patient and their GP.
By looking at all aspects of a patient’s life, rather than focusing solely on their medical condition, it is argued a GP is better equipped to guide and engage with a patient.
Through allowing a patient and GP relationship to mature, it is claimed more ‘adult conversations’ will follow, enabling a GP to offer more personalised advice rather than dictating a course of treatment.
“It was great to have someone that cares and doesn’t just want to tick a box,” said Christine Searle, a patient at NHS Tower Hamlets, which piloted the care planning approach.
“It is very important to not just focus on a person’s LTC but how it impacts their day-to-day life. This change in approach led to me controlling my diabetes rather than it controlling me.”
According to Department of Health figures, people with LTC’s account for more than 50% of all general practice appointments, 65% of outpatient appointments and over 70% of inpatient bed delays. This amounts to 70% of the total health and social spend in England.
The Royal College of General Practitioners (RCGP), claims the new approach will save the NHS time and money by reducing hospital admissions, A&E attendance and medication expenditure.
Dr Isabel Hodkinson, GP Diabetes Lead for NHS Tower Hamlets, told Management In Practice QOF anxiety is a knee-jerk reaction to the care planning idea. Such anxiety, she argues, is not valid.
“QOF is seen as a barrier to ‘care planning’ implementation because of the additional time needed for consultations,” she said.
“Many GPs are anxieties that care planning will rock the QOF apple cart but that will not happen if general practices work around QOF.”
RCGP Vice Chair Professor Nigel Mathers also told MIP the added commissioning responsibility GPs will face under the Health and Social Care Bill will aid the care planning programme as it is something that “comes naturally to them”.
