A review of the research into the Quality and Outcomes Framework (QOF) has concluded that there is ‘no convincing evidence’ that it promotes better care outcomes for patients with long-term conditions, and that the NHS ‘should look at other ways’ of motivating primary care teams.
The review, funded by the Department of Health, found ‘no evidence to suggest that the QOF influences, positively or negatively, other aspects of care, such as….holistic or personalised care, nor any evidence of its effects on patients’ quality of life, experience or satisfaction’.
It added that the QOF is ‘unlikely to advance progress towards the Five Year Forward View for the care of long-term conditions’, and that it is likely that ‘QOF diverts practices and professionals from ways of providing high-quality primary care that is not QOF related’.
But the review did find that conditions incentivised by the QOF had up to an 8% reduced rate of emergency admissions, compared to those that were not incentivised. This was mainly driven by relative reductions in emergency admission rates for coronary heart disease.
Lead author Dr Lindsay Forbes, senior clinical research fellow at the University of Kent, said: ‘If practices have achieved maximum or near maximum points under the scheme, they have little motivation to improve achievement further. And the QOF does not incentivise practices improve care for patients with the most complex needs in primary care, because these are more likely to be excepted from the scheme.’
She added: ‘In the context of a demoralised primary care workforce, it is important also to consider ways other than financial incentives to motivate primary care teams to deliver high-quality care.’
BJGP 2017, available online 26 Sep