Improving together: a new quality framework for GP clusters in Scotland.

Abstract

In her address to the Royal College of General Practitioners (RCGP) Annual Conference in Glasgow in October 2015, the Scottish Government’s Cabinet Secretary for Health and Wellbeing, Ms Shona Robison, announced her intention to dismantle the Quality and Outcomes Framework (QOF) — the pay-for-performance scheme introduced into the UK general practice contract in 2004 — and replace it as part of a new Scottish General Medical Services (GMS) contract. This contract, of which elements will be introduced through 2017 and 2018, will contain an obligation for practices to participate, as part of a ‘GP cluster’, in a new framework for quality improvement more suited to the emerging models of care in Scotland that will be required to meet the challenges facing modern health care.1 This move away from a single UK contract for GPs denotes further divergence in the NHS across the four nations.2,3 A new contract for GPs in Scotland is a historic event. This route to a Scottish contract for GPs began in 2012, after UK negotiations stalled, allowing a separate agreement between the Scottish Government and the Scottish General Practitioners’ Committee. This introduced the first discernible change in the approach to the GMS contract across the four UK nations. Further catalysts to the development of this contract have been the statutory introduction of health and social care integration in Scotland4 and a commitment from both the Scottish Government and the BMA in Scotland to work together to identify solutions to shared challenges. The healthcare system is changing in response to the demands placed upon it and must continue to do so to preserve universal access and further improve health and wellbeing within our communities. The National Clinical Strategy 5 signals the intent to transform the …