GP says scrapping QOF in Scotland was “liberating”

Dr Kevin Fernando
Dr Kevin Fernando

Scottish GP and DPC2018 speaker Dr Kevin Fernando has said the demise of the quality and outcomes framework (QOF) in Scotland was “liberating”, calling the system nothing more than a “tick box exercise”.

Fernando, a Partner of North Berwick Health Centre with a special interest in diabetes, said he had embraced the 2016 decision to scrap the payment scheme in his home country.

He said: “Certainly for conditions such as diabetes, we all know that one size does not fit all. So, it was very liberating to lose QOF and that really allowed us to focus on that patient sat in front of us.

“I know people will debate and I think QOF did have its merits. I think certainly it did improve chronic disease management, but on the downside, it was very much of a tick box exercise.”

In 2015 it was announced that the GP payment scheme, which gave surgeries money for achieving a list of outcomes, was to be stopped. The practice is still in place across England and Wales.

In the past, Fernando has done a lot of work looking at co-morbidity, frailty and polypharmacy in diabetes, and he will present on the subject at DPC2018 in November.

DPC2018 gives healthcare professionals the chance to share good practice and innovation, and Fernando is keen to find out more about the Healthier You: NHS Prevention Programme and investigate some of its outcomes which are starting to be reported.

He said: “We do things quite differently in Scotland. We don’t have the NHS Prevention programme, but there have been very early talks with the NHS Scotland, to launch our own Scottish national diabetes prevention programme.

“Similar to England and Wales, it is a significant challenge for us and what we’re seeing at the moment is just the tip of the iceberg. We’re looking at the best way to draw on all the good stuff that’s being done within the NHSDPP and bespoke that for Scotland. I’ve heard from various colleagues that it’s perhaps not working in some areas as it had been anticipated.

“I suppose what we’re seeing more and more from NHSDPP is data produced outcomes. We’ll be looking at the outcome data very closely to see if we can match some of the good results they’re producing. We’ll also be looking at the different ways they’ve implemented it throughout England and Wales and again drawing on the best of that for Scotland.”

• Dr Kevin Fernando will deliver a special hour-long session at DPC2018 on ‘Diabetes management pearls: life hacks to help people with diabetes’. Please click here for more information.

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