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<p>General Practitioner (GP) income is made up of global sum payments for carrying
out essential and additional services under the contract. Practices may also receive
further payments for specific services including:</p><p> </p><p> </p><p> </p><p>-
enhanced services – those that require an enhanced level of service provision above
what is required under the core contract. The additional payment for diagnosing dementia
falls within this category; and</p><p> </p><p> </p><p> </p><p>- the quality and outcomes
framework (QOF) - a voluntary incentive scheme that provides payment to GP practices
for how well they care for patients based on performance against a number of agreed
indicators.</p><p> </p><p> </p><p> </p><p>Specifically on diagnosis, a number of QOF
indicators are concerned with the establishment of disease registers. In order to
receive payment GPs are required to ensure diagnosis levels consistent with those
expected for their population for the following conditions:</p><p> </p><p> </p><p>
</p><p>- atrial fibrillation;</p><p> </p><p>- coronary heart disease;</p><p> </p><p>-
heart failure;</p><p> </p><p>- hypertension;</p><p> </p><p>- peripheral arterial disease;</p><p>
</p><p>- stroke and trans-ischaemic attack;</p><p> </p><p>- diabetes mellitus;</p><p>
</p><p>- hypothyroidism;</p><p> </p><p>- asthma;</p><p> </p><p>- chronic obstructive
pulmonary disease;</p><p> </p><p>- dementia;</p><p> </p><p>- depression;</p><p> </p><p>-
schizophrenia, bipolar affective disorder and other psychoses and other patients on
lithium therapy;</p><p> </p><p>- cancer;</p><p> </p><p>- chronic kidney disease;</p><p>
</p><p>- epilepsy;</p><p> </p><p>- osteoporosis;</p><p> </p><p>- rheumatoid arthritis;
and</p><p> </p><p>- obesity.</p><p> </p><p><strong> </strong></p><p> </p><p> </p><p>
</p><p>Each year NHS Employers, on behalf of NHS England, negotiates the new GP contract
with the General Practitioners Council of the British Medical Association. This includes
discussion of changes to the Enhanced Services and QOF.</p><p> </p>
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