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Life goes on

Primary Care Blues

Cornelius Rubeus

Tuesday, 10 April 2012

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blog_life_goes_on.jpg“One knows so well the popular idea of health - The English country gentleman galloping after a fox - The unspeakable in full pursuit of the uneatable…”

The Practice QoF Hunt is over for another year… the return is in and all the last ditch attempts to capture missing QoF points are done with… In the end we were only foxed by some reluctant mental health patients – who escaped our baying hounds without being weighed / smeared / venesected – 4.16 points worth or £602 if you are really interested…

People more erudite than I have asked if QoF has been good for patient care. Undoubtedly, it has incentivised us to have a more organised, systematic approach to chronic disease management and secondary prevention. There is, however, a lack of evidence that QOF has directly improved health or reduced inequalities. Whilst QOF encourages a clinical and mechanised approach to managing chronic disease, it does not necessarily support holistic care or promote self-care and management.

A common concern in relation to QoF is that what doesn't get incentivised may get marginalised. When QoF was implemented, it was in a favourable financial climate. We had some capacity to hire new staff and do more QOF activity without having to do less non-QOF activity. That financial climate has changed. Resources are tight; budget constraints are hard. In these more austere times it seems likely that we will be forced to ensure that ‘core’ PMS contracts are fulfilled and the QOF bounty is optimised, rather than necessarily responding to local patient non-QoF needs – to do otherwise may be financial suicide.

Not uneatable, but rather unpalatable…

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Cornelius Rubeus

Dr Rubeus is a hardworking, jobbing GP who trained in the North of England and now works in an inner city setting. He feels passionate about the changes affecting primary care and is not afraid to voice his views. He has his patient’s best interests at heart and wants General Practice to remain as the bedrock of the NHS for years to come.

How would qualify the communication between primary and secondary care services? (See OnMedica News 20/04)

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