Source · Select Committees · Health and Social Care Committee
Fourth Report - The future of general practice
Health and Social Care Committee
HC 113
Published 20 October 2022
Recommendations
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 …
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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.
Department of Health and Social Care
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34
Accepted in Part
Para 117
Imperative for NHS England to abolish QOF/IIF, reinvesting funds into core contract.
Recommendation
NHS England should abolish the Quality and Outcomes Framework and Impact and Investment Framework and re-invest the funding in the core contract, weighted to account for patient demographics including deprivation, to incentivise continuity of care.
Government Response Summary
The government partially accepts, stating that for 2023/24 there will be a 25% reduction in QOF indicators and the IIF will be reduced from 36 to 5. It will formally consult on the future of QOF during 2023/24 and engage with stakeholders on IIF reform.
Department of Health and Social Care
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35
Accepted in Part
Para 118
Need for NHS England to improve GP outcomes data, focusing on key measures.
Recommendation
In particular, NHS England should focus on significantly improving the outcomes data provided to GPs by focusing data collection and analytical resource on outcomes measures rather than the process data and reporting required by these micro- incentives.
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Government Response Summary
The government partially accepts, committing to explore ways to strengthen outcomes data collection and monitoring during a 2023/24 consultation on the Quality and Outcomes Framework, while also stating the importance of process data.
Department of Health and Social Care
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36
Accepted in Part
Para 119
NHS England's role supporting ICSs to implement gain sharing for reduced secondary care.
Recommendation
NHS England should support Integrated Care Systems to implement gain sharing so that Primary Care Networks and individual practices that support the reduction of secondary care expenditure, such as through reducing unplanned admissions, are able to share in the financial …
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Government Response Summary
The government partially accepts, committing to provide "light touch support" like sharing case studies for gain sharing, but notes difficulties in proving causality for direct financial transfers. They also state work is ongoing to explore additional opportunities to reward primary care.
Department of Health and Social Care
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42
Accepted in Part
Reaffirm Government commitment to GP partnership model and detail support for its future.
Recommendation
In response to this Report the Government should reaffirm its commitment to maintaining the GP partnership model and explain how it will take forward our recommendations to better support the partnership model, alongside ongoing work to enable other models of …
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Government Response Summary
The government partially accepts the recommendation, reaffirming no policy to abolish the GP partnership model and highlighting existing investments to support general practice, while also expressing a desire to support a range of primary care provision models.
Department of Health and Social Care
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44
Accepted in Part
Para 141
Consider adopting Scottish GP premises model and increase investment in general practice estate.
Recommendation
The Government should consider adopting the approach to GP premises taken in Scotland and conduct its own analysis of whether this would be viable for general practice in England. More widely the Government must make additional investment available for the …
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Government Response Summary
The government partially accepts, declining to adopt the Scottish approach due to stakeholder views, but commits to undertaking analysis of the GP estate and considering alternative models. They will also update planning guidance to support primary care infrastructure in new developments.
Department of Health and Social Care
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Conclusions (1)
43
Conclusion
Accepted in Part
Para 140
Despite the risk associated with GP premises continuing to be a significant burden on existing GP partners and a barrier to entry for potential new partners, little progress appears to have been made on this issue. Until the Government grips this issue properly it will continue to seriously undermine GP …
Government Response Summary
The government partially accepts, agreeing to undertake analysis of the GP estate and consider alternative models. They will also update planning guidance to ensure primary care infrastructure is referenced and considered in new developments.