NHS England has announced that GPs will be allowed to replace the national Quality Outcomes Framework (QOF) agreement with their own locally agreed deals without NHS England approval.

Under the proposals, which will be finalised later this week, GPs will still be able to continue with the nationally agreed QOF deal, regardless of whether their Clinical Commissioning Group (CCG) has introduced a local deal or not.

The proposals, outlined in Proposed next steps towards primary care co-commissioning, follows a similar model to the one announced in Somerset last year, in which the area developed its own deal allowing its CCG to ‘co-commission’ primary care and where two-thirds of practices opted to drop the QOF.

The document sets out the parameters around what areas of primary care CCGs will be able to commission and also proposes that the committees responsible for co-commissioning within CCGs must not be chaired by clinicians and must not have a GP majority in an attempt to manage potential conflicts of interest.

The proposals on locally negotiated quality programmes would allow CCGs to establish a regional scheme without the approval of NHS England, although the documents suggests that any CCG wishing to develop a local incentive scheme should first consult with the Local Medical Committee (LMC).

However, the General Practitioners’ Committee (GPC) has urged caution over local schemes in the past, saying the move could have the unintended consequences of GPs doing the same work for less resources and then having to work hard to earn that resource back.

A spokesman for the GPC said he was concerned that the proposals would merely reinstate the powers that Primary Care Trusts (PCTs) had over contracts and is concerned that it is another move back to PCTs as NHS England devolves yet more responsibilities.

The NHS Alliance has welcomed the proposals, however, saying that the QOF has become too inflexible and has too often been a question of point-scoring or box-ticking, so following the model being worked through in Somerset is ideal.