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GP bonus scheme 'not tackling health disparity'

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There is no evidence a financial bonus scheme for GPs has prevented people becoming ill despite costing billions of pounds, a new report suggests.

The Quality and Outcomes Framework (QOF) has also done little to reduce health inequalities between different groups, according to the study from the King’s Fund think-tank.

Introduced in 2004, QOF financially rewards GPs for meeting a range of targets.

These include improving the management of chronic diseases such as asthma and diabetes, improving how practices are organised and enabling patients to give feedback on their experience of a surgery.

Offering “extra” services, such as maternity and child health, can also attract QOF points.

As a result of QOF, GP practice partners saw their incomes rise, on average, from £72,000 in 2002/03 to £113,000 in 2005/06.

More than 20% of a GP’s annual income is now related to quality, and payments account for around a third of average practice earnings, figures show.

In the first year of QOF, practices achieved more than 90% of available QOF points, putting the cost in 2005/06 alone at £1.15bn.

The study found little incentives for GPs to try to improve public health.

And while QOF has been effective in pushing practices to adopt improved approaches to, for example, identifying and detecting illness, there is no evidence it has prevented ill health.

The report said many of the QOF targets were “process” measures which include GPs keeping a record of data such as smoking status, cholesterol, blood pressure and body mass index for patients.

Some points are also awarded for outcomes, such as treating chronic heart disease with beta blockers, or encouraging lower levels of cholesterol or blood pressure in higher risk patients.

The report was based on an analysis of routine data and interviews with practice and primary care trust staff in England.

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Readers' comments (3)

  • There never has been evidence of this, but money has always been thrown at Doctors, particularly GP's, because they are such a powerful group. And the government still thinks it's a good idea to hand them sole control of the NHS budget? What a joke.

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  • Agree with Mike above. In fact I moved jobs in 2004 where pre QOF, a "professional" GP practice were keen to do the right thing and it exceeded QOF. When I moved to carry this forward to a different practice, the introduction of QOF was an excuse to tick the boxes when patients came in to see GPs for other reasons so the nurse led cardiovasular process of screening and preventing was scrapped.

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  • its all a scam, cannabis oil is the panacea toxic drugs do not extend life expectency

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