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Experts warn QOF may not be best for patients

The practice earns points system reaps in financial resources but may not be giving patients what they need, experts warn in the British Medical Journal (BMJ).

The quality and outcomes framework (QOF) has been hailed as a successful system for providing quality care, but Dr Iona Heath and colleagues now warn that GP performance targets may be leading to lower levels of healthcare.

The team says that clinical care needs to be tailored to individual patients rather than using a "mechanistic approach".

They say QOF diminishes the responsibility of doctors to think about their individual patients, and instead encourages them to concentrate on treatment processes.

It is argued that even the framework aiming to tackle health inequalities has the potential to work in the opposite direction.

Dr Heath and colleagues say socially disadvantaged people are more likely to be listed as exceptions from QOF payments, and then risk receiving proportionally less attention.

They add that evidence shows that payment for performance systems reward high achievers and penalise low achievers, exacerbating inequalities.

The researchers conclude that emphasis on processes brought about by the framework should not be allowed to distract from the fundamental aims of medical care.


Your comments: (Terms and conditions apply)

"My husband and I attended a well-person clinic and were subjected to a series of questions and a blood pressure check. We were singularly unimpressed and later discovered that it had been carried out by an HCA. There wasn't even a urine check. This seemed to be just was box ticking to earn the GPs more money" - Name and address supplied

"The system is more focussed on a tick-box basis and individual practices are not given the time and care to suit their needs. The system should not be target set templates, the quality of care should continue, and once a year the data should be retrieved and compared to targets aimed by NHS. GPs shouldn't be told to be expected to meet their targets, as clinicians they ought to know what is the best care and what protocols to follow according to illnesses. It should be checked to prove that quantity follows the quality" - Ms.Prabesh.Thangarajah CM/PN Ealing PCT