GPs in Somerset have been given permission to ditch reporting against the majority of quality and outcomes framework indicators in favour of a locally developed approach, in a move seen as a “significant departure” for NHS England.
HSJ understands the Somerset Practice Quality Scheme will mean a significant reduction in bureaucracy for practices in the county that have taken part.
Under the revised scheme, they will only be required to report against a fraction of the indicators in the 2014-15 QOF. Release of the rest of the funding available for QOF will be dependent on the local area team being satisfied that practices are making progress on improving the sustainability and integration of services.
It is the first time NHS England, which commissions primary care, has approved a localised alternative to the much maligned national framework.
Harry Yoxall, medical secretary of the Somerset Local Medical Committee, told HSJ practices would continue to carry out the clinical practices contained in QOF but would use the time saved by not measuring and verifying data to improve the integration and sustainability of patient services.
He said: “We are very pleased that the area team and CCG have the faith in Somerset GPs not only to keep providing the clinical priorities of QOF without someone standing over their shoulder, but to develop improved services.”
Practices will be required to produce quarterly reports to demonstrate to the area team what improvements have been achieved and set out future plans.
HSJ understands Somerset Clinical Commissioning Group led the bid to vary QOF in response to low morale and, recruitment and retention difficulties.
The CCG approached the Bristol, North Somerset, Somerset and South Gloucestershire local area team earlier this year. The area team gave GPs in Somerset permission to stop reporting against QOF for the final quarter of 2013-14 in order to develop an alternative model by April 2014.
HSJ understands the plans were approved by NHS England earlier this week.
One senior south west source with knowledge of the discussions said the decision was a “signal” that NHS England’s executive board was prepared to look at different things, although they were unlikely to want a “mass abandonment of QOF”.
The source added: “If you think that NHS England was set up as one organisation with a single operating model it’s a significant departure.”
HSJ understands NHS England felt the area team had made a strong case for departing from the national framework, but plan to monitor Somerset’s progress closely before considering requests from other areas for similar freedoms.
Mr Yoxall said about 70 per cent of practices in the administrative county were interested in joining the scheme initially but due to the delay in getting approval the take up was likely to be lower.
Practices in Taunton, the north east of the county and south Somerset are understood to be adopting the scheme.