The 2004 pay deal for GPs has never been widely popular with the public, mainly because it awarded doctors a large pay rise while allowing them to opt out of out-of-hours coverage, which the vast majority went on to do. But there are elements of the deal which have been unpopular with GPs too.

One particular bone of contention in recent years has been the QOF system, which was established by the 2004 deal and rewards surgeries with funding for delivering a list of services to patients. These include monitoring high blood pressure, recording whether people smoke and offering them advice on how to quit.

In theory, the system is a good one, as you can see what individual GP practices are delivering, incentivise them to address priority issues and reward those who do it well. But as the years have passed, the problems with QOF have become more obvious. Many GPs feel that sticking to a list of prescribed list of services has meant patients are less able to talk about what is bothering them; other doctors believe the entire system has become a bureaucratic nightmare - one practice that carried out an audit of the amount of paperwork they had to complete found that it had increased by 250 per cent in eight years.

So it should come as no surprise that the announcement by Health Secretary Shona Robison at a GP conference in Glasgow that the QOF system is being dismantled was greeted by applause from the audience. The details of what will replace is are still vague, but it is likely that GP surgeries will work together in clusters providing quality assurance between themselves rather than having to work to a prescribed list. For example, a group of surgeries might look together at the help they are offering to problem drinkers, how well this is going and how it should be improved rather than individual surgeries being rewarded for offering one consultation on alcohol abuse to patients, as happens under the current system.

Dr Alan McDevitt, chair of the BMA's Scottish GP committee, says the changes will have a positive effect on practices by reducing their workload and allowing doctors to focus much more on the needs of their patients, but, as the details are worked out, some safeguards will need to be introduced to ensure the new system is working as well as possible.

The first should be some kind of national framework that reflects the priorities of the Scottish Government and to which the clusters of practices can be compared. Some might feel this is overly prescriptive and repeats the mistakes of QOF, but the danger of not providing an overall framework is that the clusters will be driven by the particular interests of GPs in the clusters and that localised distortions will start to appear.

To work as effectively as possible, the new system will also need to include some form of reporting system so that the transparency which QOF sought to establish can be maintained. And a way of the clusters sharing their work between themselves should also be considered.

However, even with such safeguards built in, there is one other ingredient which must be guaranteed: adequate funding. The QOF system rewards surgeries with funding for delivering the services they are asked to and the replacement must not lead to any drop in that funding. Indeed, like other parts of the NHS facing the prospect of an ageing population with increasingly complex needs, GPs surgeries need not just a guarantee that their funding will stay the same – they need a promise that it will be increased.