Mass Practices Close – Extended Hours Disparity – Polyclinic Takes Staff

From the Fibromyalgia FMS Global News Desk of Jeanne Hambleton

Courtesy newsletter
John Robinson – PulseToday Editor

Practices who knew they were going to lose out when the square root formula for QOF prevalence was phased out from April may have been expecting some help from their trust to cover the shortfall, but it seems many PCTs are to let practices go to the wall. The GPC admitted last week that possibly hundreds of practices will be at risk of folding because PCTs are failing in their duty to agree local deals to prop up practices, some of whom are set to lose £100,000 or more. Are you affected? Send us your feedback here.

Extended hours are penalizing smaller, poorer practices who find it more difficult to open in the evenings and at weekends, our investigation has found. Whereas 75% of practices in the least deprived urban areas and 80% of 8-partner or larger practices are opening longer, only 44% of singlehanders and 61% of practices in the most deprived areas are.

Evidence is emerging already of how polyclinics will affect practices around them. The first GP-led heath centre has taken staff and patients from existing local practices. A practice close to the Hillside Bridge centre in Bradford reported two of its nurses had been recruited on significantly better pay. Approaching half of the patients registered at the centre have moved from local surgeries.

Ed: What happened to loyalty and the family doctor? Dr Chapman and Dr Sheridan of Lordship Lane, north London, were my doctors through childhood, teenage, marriage and the birth of my first child. They were family friends and used our first names. We were not numbers on a database.

In later life another doctor comforted me as my Father died. Can polyclinics replace that? My doctor knows I have fibromyalgia. Will some nurse in a polyclinic say ‘Fibro what?” The polyclinic doctors may be among the huge percentage who have received no training in fibromyalgia, because it was not there. How does that help the plight those with fibromyalgia who are STILL being told this syndrome is all in their head and imaginary. Believe me IT IS REAL.


Proposed changes to the quality and outcomes framework for the financial year 2008/09

The Department has written to all General Practices to inform them of proposed changes to the Quality and Outcomes Framework which will apply from 1st April 2008. The Department will make and publish the changes to the SFE, once they have been agreed, as soon as possible.

There is a public consultation document setting out proposals for how a new independent and transparent process for recommending Quality Outcome Framework (QOF) indicators led by NICE should work. The Department of Health will publish the responses and publish a report on how the consultation process influenced the development of policy. This was launched October 30 2008 and the consultation closed February 2 2009.

The Department of Health website

From Wikipedia, the free encyclopedia

The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners (GPs) in the National Health Service (NHS) in England and Scotland. It was introduced as part of the new general medical services (GMS) contract in April 2004. It is supported by an information technology system called QMAS.
The QOF rewards GPs for implementing good practice in their surgeries. The QOF comprises a range of criteria, which are grouped into 4 domains: clinical, organisational, patient experience and additional services. The criteria are designed around best practice and have a number of points allocated for achievement. At the end of the financial year the total number of points achieved by a surgery is collated by the QMAS system, which then converts the points total into a payment amount for the surgery, which takes account of the size of the practice and the number of patients diagnosed with chronic illness.
The QOF system is supervised and audited by NHS primary care trusts (or Health Boards in Scotland), who make the related payments from their budgets.

Participation in the QOF is voluntary for each GP practice but the achievement standards were set so low that most practices participated and got (and continue to get) a considerable additional income through the QOF. In the 2004 contract the practice could accumulate up to 1050 ‘QOF points’ (depending on level of achievement for each of the 146 indicators.
A typical clinical indicator would be the proportion of patients with coronary heart disease who had cholesterol measured in the previous years. Organisational indicators included such things as practice leaflets and practice staff education.

Exception reporting

The level of achievement recorded depends on the GP treating the patients with the relevant complaint. But not all patients are treatable or willing to be treated. In order for the GPs not to lose points on account of circumstances that are outside their control they can exclude those patients from counting towards their achievement by “exception reporting” them. Exception reporting is allowed for:
patients who are refusing to attend;
patients for whom chronic disease reporting is inappropriate (e.g. terminal illness,
extreme frailty);
newly diagnosed or recently registered patients;
patients who do not show improvement;
patients for whom prescribing a medication is not clinically appropriate;
patients not tolerating medication;
patients refusing investigation or treatment (informed dissent);
patients with supervening conditions;
cases where diagnostic/secondary care service is unavailable.

For more details log on to

About jeanne hambleton

Journalist-wordsmith, former reporter, columnist, film critic, editor, Town Clerk and then fibromite and eventer with 5 conferences done and dusted. Interested in all health and well being issues, passionate about research to find a cure and cause for fibromyalgia. Member LinkedIn. Worked for 4 years with FMA UK as Regional Coordinator for SW and SE,and Chair for FMS SAS the Sussex and Surrey FM umbrella charity and Chair Folly Pogs Fibromyalgia Research UK - finding funding for our "cause for a cure" and President and co ordinator of National FM Conferences. Just finished last national annual Fibromyalgia Conference Weekend. This was another success with speakers from the States . Next year's conference in Chichester Park Hotel, West Sussex, will be April 24/27 2015 and bookings are coming in from those who raved about the event every year. I am very busy but happy to produce articles for publication. News Editor of FMS Global News on line but a bit behind due to conference. A workaholic beyond redemption! The future - who knows? Open to offers with payment. Versatile and looking for a regular paid column - you call the tune and I will play the pipes.
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