Asked by: Adam Holloway (Conservative - Gravesham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if NHS England has a mechanism to investigate and retrieve funds paid to GP practices that claimed high Quality and Outcome Framework (QOF) achievement scores, where CQC Inspectors have subsequently found the scores of those practices were lacking Integrity.
Answered by Steve Brine
Commissioners are required under the General Medical Services Statement of Financial Entitlements Directions 2013 to ensure that all Quality and Outcome Framework (QOF) payments claimed and made are based on accurate and reliable information. In the event this is untrue, then the Commissioner may withhold payment of all or part of an Achievement Payment that is otherwise payable.
QOF guidance also sets out the verification process in relation to QOF payments, including any requirements in relation to post payment verification. In relation to an unfavourable Care Quality Commission (CQC) inspection, Commissioners would be expected to follow the processes set out in NHS England’s published Framework for responding to CQC inspections of general practitioner practices.
The Commissioner may recover the money paid by deducting an equivalent amount from any payment payable, and where no such deduction can be made; the contractor must pay that equivalent amount.