A clinical commissioning group in the south of England has agreed a variation to the GP quality and outcomes framework with nearly all its practices, to encourage more community based care.

  • Practice income will be guaranteed regardless of performance in some areas of QoF
  • It will create ‘headroom’ for practices to develop care and support planning
  • Follows controversial variation from QoF in Somerset

Aylesbury Vale Clinical Commissioning Group is reducing GP practices’ requirement to report on elements of the QOF linked to several long term conditions during this financial year.

The move follows a controversial decision last year by Somerset CCG, agreed by NHS England, to abandon the majority of QOF indicators in favour of a local approach. It is not known whether any others have followed its lead, but in June none of the 63 groups with delegated responsibility for GP commissioning told HSJ they expected to do so in 2015-16.

Aylesbury Vale told HSJ it had agreed to “reduce the formal reporting requirements of the elements of the quality and outcomes framework” associated with diabetes, dementia and respiratory conditions. The plan was approved by NHS England late last month.

The CCG will “offer leniency around the requirement for payment to be linked to the [QOF]”. For the areas of the QOF that are set aside, practices will be paid “based on their historic 2014-15 [QOF] outturn, even if the 2016-16 achievement is less”. These payments will be uplifted by 5 per cent from 2014-15 levels.

The move intends to create “headroom” for GP practices to develop care and support planning, designed to help those with long term conditions better manage their health.

The CCG will also provide each practice signed up to the scheme with £4,000 additional funding to cover the cost of training and project management.

The initiative forms part of a wider primary care strategy developed by Aylesbury Vale and Chiltern CCGs to move more care into the community.

Aylesbury Vale said 14 of its 19 member practices had signed up so far, accounting for 150,000 of the area’s 200,000 registered patients.

Each practice is also to be offered personalised care planning training sessions.

The CCG has in 2015-16 taken on joint commissioning responsibility for GPs with NHS England, rather than full delegated powers. It said that as part of a “quality assurance process” it would be observing QOF achievement throughout the year, alongside NHS England, to identify any “significant outliers”. The CCG’s care and support planning team will speak to any practices it finds.

It is planning a second stage from April 2016, which it expects to include “improving patient reported outcomes… and may include the inclusion of alternative quality markers as developed through our disease specific redesign programmes”.