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Could Scottish ‘GP Clusters’ Be the Key to Replacing QOF?

As part of GP contract changes last year in Scotland, practices were asked to form regional ‘GP Clusters’ to help them pool their knowledge and resources, improve the quality of outcomes for patients and work together to offer more services.

Last week, the Scottish government gave the initiative a sizable boost when it announced investment of £7.5 million to encourage more practices to become part of the clusters.

Made up of GP practices working in groups of 4 to 8 practices, clusters cover 20,000 to 40,000 patients – the variations are due to differences in practice sizes and the geography of each local area.

Interestingly, the removal of QOF in Scotland was part of the same set of negotiations that saw clusters introduced. They were described in recent government document Improving Together as an “opportunity… to reconsider how we approach quality”. RCGP Scotland chair Dr Miles Mack has laid out his hope for clusters to be “peer based and values driven”.

The idea is for GP practices and GP clusters to have oversight and direct involvement in improving the quality of all health and social care services provided to patients within their boundaries. This includes the current chronic disease management programme and use of secondary care services.

Improving Together puts clusters at the heart of an “alternative route to continuously improve the quality of care that citizens receive” in Scotland, moving away from box-checking and embracing learning, development and improvements for the benefit of local communities.

GP clusters are also spreading across Wales - the Welsh National Assembly is keeping a close eye on how effective they’ve been at improving the quality of health and social care services provided to patients.

QOF has already disappeared from the healthcare landscape in Scotland and is widely seen as on the way out in the rest of the UK. Could clusters be the key to replacing QOF - a more personalised approach to care and quality that supports the integration of social and health care on a local and national basis? For now it’s a possibility that shows a lot of promise.

Let us know if your practice is operating in a cluster and share your experiences with other PMs in the comment section below. Do you see clusters as having a bright future in primary care?


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