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QOF fully reinstated from today despite concerns

by Beth Gault
1 April 2022

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QOF and all its requirements is fully reinstated from today (1 April), despite concerns that the system does not take into account the significant impact of the pandemic on long-term conditions and could financially penalise practices.  

NHS England announced the resumption of the payments system in December, after QOF was part-suspended in 2021/22 to free up time for Covid vaccinations. At the time, it set out various temporary GP contract changes to support the programme, including changes to QOF and Investment and Impact Fund (IIF) indicators.  

The body confirmed that these temporary changes to QOF would end in March 2022 in a letter regarding the GP contract at the start of the month.  

It said: ‘No new additional indicators will be added to QOF when the temporary income protection arrangements come to an end in March 2022.’ 

It added that the quality improvement modules (QI) for 2022/23 would focus on optimising patients’ access to general practice and prescription drug dependency.  

However, the BMA published an update in March saying that NHS England’s choice to fully reinstate QOF and all its requirements ‘does not seem to take into account the significant impact of the pandemic on all long-term conditions’.  

It added that NHSE had ‘declined to address’ the BMA’s request for additional support for some QOF indicators.  

The BMA said: ‘Despite GPC England’s requests for additional support for childhood immunisations, in view of data from around the country on achievement, NHSEI has declined to address this as part of the 22/23 contracting round.  

‘We believe changes should be made to these indicators to enable practices to deliver more for their patients without being financially penalised. NHSEI refuses to make changes to these indicators in-year, despite this being done in the past.’ 

The body also expressed concern over impact to payments, saying: ‘We have also highlighted the acute challenges practices will face in light of impact to IOS payments for many practices; this too has not been considered as part of the 22-23 contracting round.’ 

Dr Kieran Sharrock, deputy chair of GPC England at the BMA, told Management in Practice today (1 April) that GPs are ‘incredibly anxious’ about QOF being restated and hitting new targets would be ‘almost impossible’ for some practices amid high demand for GP services and fewer staff.

‘Suspending the quality and outcome framework (QOF) – a voluntary, annual reward and incentive programme for GP practices  – during the pandemic was vital to freeing up capacity so that GPs could prioritise their time and meet ever-growing patient demand,’ Dr Sharrock said.

‘Two years on, however, and this demand has not ceased. In fact, as QOF is reinstated, pressures on our services have increased, as we continue to carry out our day-to-day work on top of delivering the nation’s largest-ever vaccine rollout and plough through the mounting backlog of care. Many practices are overwhelmed, especially those who are now operating with considerably fewer staff.

‘GPs and their teams already feel undervalued, and NHS England’s decision to push ahead with reinstating QOF, without recognising the pressures that practices are already facing, will only exacerbate this.’

Though no amendments have been made to the content of QOF, the value of a QOF point will increase by 3.2% from £201.16 to £207.56 due to a change in the average number of patients per practice.  

It comes after RCGP chair Professor Martin Marshall called for the QOF system for GP payments to be scrapped, saying it ‘doesn’t make sense whatsoever’.