A report by the Bow Group this week argues that the new framework on which GP commissioners will be assessed must not be too 'prescriptive'.

Overall, the Bow Group is cautiously enthusiastic about the health White Paper, describing it as the most radical since the creation of the NHS.

Depending on the success of the White Paper's reforms, health secretary Andrew Lansley will 'either be remembered as the great reformer or the great failure', it said.

But it warns central planning of targets has been one of the main flaws of the QOF and that the new NHS Outcomes Framework could face the same problems. The paper says the focus of the framework on outcomes is encouraging.

But it added: 'It will be crucial that this framework is not too prescriptive and still allows local consortia to innovate.'

In a report earlier this year, the Bow Group said the QOF's performance in reducing health inequalities is 'at best mixed and at worst disappointing'.

The latest report argues that central planning is 'an ineffective and flawed way of fostering a system that allows for the prioritisation of local healthcare imperatives'.

Setting QOF targets centrally meant they could not reflect local needs, it said. The report said it would be 'deeply regrettable' if this was echoed in the new outcomes framework.