Over the past couple of weeks it has emerged that GP practices in some areas of the country have reached agreement with NHS England local area teams to take a hiatus on the Quality and Outcomes Framework (QOF) reporting until March 31 this year. Devon and Cornwall CCG area team has agreed this approach, with the aim of freeing up time and resources allowing them to focus on maintaining the health of vulnerable and frail patients and alleviating the winter pressures on the NHS by keeping them well and out of hospital. There are mixed views on this approach, but it has been suggested that it will be beneficial for meeting patient, practice and CCG aims pre-April.
In a seperate move, practices in Somerset are working with their CCGs to negotiate a local replacement for the existing QOF. Where practices are engaged and practicing up-to-date evidence-based medical care, the outcomes of such a local negotiation could be beneficial for patients, allowing GPs to create indicators for care directly suited to their patients needs.
A practice nurse asked me this week how involved the practice nurses were in these negotiations. This would be key, she believed, to successful outcomes since it is in many cases the practice nurses that run clinics for the management of long-term chronic illnesses, thus ensuring practices meet the QOF indicators. It will be the way practice nurses' time is spent that will change, although workload is unlikely to. Therefore, nurses should be instrumental in negotiations to ensure that box-ticking care is replaced by meaningful local indicators relating to patient population need. IN would be interested to hear your views on the current QOF, the sense in the proposed alterations, and from any nurses involved in negotiating changes at a local level. Practice nurses have an opportunity to influence outcomes.