Clinical commissioning groups may be encouraged to take on responsibility for the quality and outcomes framework for GP practices within their area, under NHS England plans.
New guidance from the national organisation says arrangements for the GP practice pay-for-performance regime are likely to be part of a “standardised model” it will use to delegate co-commissioning powers to CCGs.
A NHS England discussion document on primary care co-commissioning issued to CCGs last week states: “Our emerging thinking is that standardised model of delegation would make most sense for practical reasons.”
It says the functions “most suitable for full delegation”, set to be part of the standard model, are general medical services (GMS) and personal medical services (PMS) contracts, the quality and outcomes framework (QOF), enhanced primary care services, and property.
“We have not detected an appetite in CCGs to take on revalidation and performer’s lists, and many CCGs also believe that individual and practice performance management aspects of contract management should not be open for delegation,” it adds.
In June, NHS England approved practices in Somerset CCG to move off the national QOF payment framework - an arrangement developed by Somerset CCG - in a highly controversial move. It is not clear whether delegating responsibility for QOF to CCGs would allow them to agree for practices to move off it.
The document also reveals NHS England has told CCGs to re-submit bids to take on co-commissioning responsibility by 5 January. It states: “Not all CCGs agree with how their CCGs were categorised during the initial analysis.
“Therefore we are proposing that all CCGs get a fresh approach to decide upon their preferred approach to primary care commissioning.”
CCGs were originally asked to submit bids in May, and NHS England has said 196 were received, from the total 211 CCGs.
The final proposals are due to be signed off by 16 February by a new commissioning committee which NHS England plans to establish, then go live in April.
It says NHS England will “support CCGs to move towards implementing co-commissioning arrangements” except where they have “serious governance issues or [are] in a state akin to ‘special measures’”.