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Changes to QOF could mean more health inequalities

OnMedica staff

Tuesday, 13 January 2009

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The new Quality and Outcomes Framework (QOF) should not be managed by the clinical watchdog NICE nor allow PCTs to adapt indicators to local need, according to doctors’ leaders.

The BMA, publishing its formal response today to the government consultation on the QOF, says proposed changes to QOF could mean it is inappropriately influenced by political imperatives and could expose patients to postcode healthcare in primary care.

The Department of Health consultation, Developing the QOF: Proposals for a new, independent process, says the QOF should be brought under the remit of NICE and that PCTs should be able to select some indicators based on local need.

The BMA’s GP Committee, however, has rejected these proposals saying that localising the QOF “will be seriously detrimental to the already reduced gap in health inequalities” which its introduction achieved and may threaten consistency of care.

The BMA said it was more important to maintain a UK-wide, evidence-based QOF to maintain its status as a world leader in primary care quality standards.

The response says: “We do not believe that NICE is a body completely independent of government influence and do not feel that it would do a better job than the current independent expert group.

“This would affect the profession’s and patients’ confidence in the QOF as well as risk undermining the professional relationship of GPs with their patients.”

The proposed pace of change was unrealistic, according to the BMA, and would threaten both delivery and quality of care.

The BMA was also concerned that the decision regarding the involvement of NICE already appeared to have been made.

Dr Laurence Buckman, chairman of the BMA’s GP Committee, said: “It is vital all LMCs respond to this consultation. Even though this is an English consultation, the proposed changes will have an impact on QOF across the UK. As it stands the changes proposed in this consultation will create rather than get rid of health inequalities.”

The consultation closes on February 2nd.

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