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NHS England proposes QOF and GP contract changes

What will be the outcome of the review into QOF?


NHS England is asking for views on possible reforms to the GP contract and on a review of the quality and outcomes framework (QOF) as part of the proposed long-term NHS plan.


It says the proposals could make 2019 the year of the most substantial changes to the GP contract since 2004, when the current contract was agreed.


Drivers of the reforms include:

  • extra money promised by funding settlement announced in June by Prime Minister Theresa May
  • tackling workforce pressures on general practice
  • supporting the national development of 1,000-1,500 primary care networks as an expanding service delivery unit
  • supporting take-up of digital technology


The GP contract is being looked at to bring it in line with the changing needs of a growing and ageing population and increased use of digital services locally.


For QOF, the review proposes five main changes

  • to modify indicators in up to half the scheme
  • to update exception reporting, to be termed the ‘personalised care adjustment’ for all indicators
  • to include a new quality improvement (QI) domain
  • to undertake moderate retirement of indicators (NHS England says a case could be made for up to a quarter of current indicators)
  • a national trial of a [primary care] network level QOF, with a select number of sites


NHS England has invited responses on two documents:


Both of which will feed into NHS England and the BMA general practitioners committee in England discussions concerning next year’s GP contract.


Primary care is one of the four national service improvement priority areas identified in Next steps on the five year forward view.


Further information

NHS England: Help shape modern primary care says NHS England as part of NHS Long Term Plan

NHS England: Board meeting papers

Health Service Journal: ‘Biggest reform of GP contract since 2004’ planned by NHS England

British Medical Journal: Quality and Outcomes Framework faces radical reshape in England but will be retained