Source · Select Committees · Health and Social Care Committee
Recommendation 33
33
Accepted in Part
Current general practice targets and incentives are overly bureaucratic, failing to improve outcomes.
Recommendation
Accountability and quality improvement are both extremely important in the NHS but it is clear that the current system of targets and incentives in general practice is overly bureaucratic, is not having the desired effect on outcomes, and will not enable GPs to change the way care is delivered. In particular, the current system of incentives does not encourage GPs to deliver high levels of continuity and also does not fund GPs for the additional work that will be required to manage more care in the community and reduce hospital admissions. Moreover, the Government’s decision to introduce an additional two-week wait target for GP appointments, while well-intentioned, does not address the fundamental capacity problem causing poor GP access. The Government and NHS England need to be bolder and empower GPs to exercise their professional judgement in the best interests of their patients. (Paragraph 116) 44 The future of general practice
Government Response Summary
The government partially accepts, committing to a 25% reduction in QOF indicators and a reduction of IIF indicators from 36 to 5 for 2023/24. It will formally consult on the future of QOF and engage on IIF reform during 2023/24.
Government Response
Accepted in Part
HM Government
Accepted in Part
Partially accept. The Department recognises the Committee’s concern that there are too many micro-incentives in general practice. Reflecting this in the short-term, for 2023/24 there will be a 25% reduction in QOF indicators (from 74 to 55) as QOF disease register indicator points are awarded to practices based on 2022/23 outturn and releasing £97m of funding. The Investment and Impact Fund (IIF) has also been reduced from 36 to 5 indicators. Both the Department and NHS England have acknowledged that there are opportunities to improve the use of incentives, including a need to focus more on outcomes and transparency. The Delivery Plan for Recovering Access to Primary Care, published on 9 May 2023, reflects this and agrees with the Committee that there is a need for greater emphasis on outcomes and transparency. The Department and NHS England will formally consult on the future of QOF during 2023/24 and engage with stakeholders on IIF reform more generally. The Department is committed to constructive engagement with stakeholders and the profession during the reform process.