Offering general practices more money according to the number of people with long-term health conditions they treat, for example, with diabetes, cancer or dementia, does not lead to improved care, according to a study by Centre for Health Services Studies at the University of Kent.The study, led by Dr Lindsay Forbes, Senior Clinical Research Fellow. is published online by the British Journal of General Practice on 26th September 2017 (http://bjgp.org/content/early/recent). Commissioned by NHS England, the study looked at the Quality and Outcomes Framework (QOF), the world’s largest pay-for-performance scheme in primary care. Around 99% of GPs in England are part of the QOF around 10-15% of income for general practices is derived from the scheme.
CHSS carried out a systematic review of the effect the QOF has on a broad range of patient outcomes such as personalised care, self-care, patient experience, coordination of care and mortality rates, among others. The study found no evidence that the QOF leads to better coordinated care, more holistic care, better encouragement to self-care, or improved patient experience or involvement in decisions. It also had no effect on mortality rates. It found that the QOF may be associated with some very modest positive effects in limited areas only.
CHSS concluded that NHS should consider more broadly what constitutes long-term high quality care and find other ways of motivating GPs and primary care teams beyond monetary rewards.
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