Incentivise GPs to target those most in need, NAO says

The quality framework has failed to incentivise GPs to work with patients in the most deprived areas, a National Audit Office (NAO) report on health inequalities says.

The report evaluates the DoH's attempts since 1997 to reduce health inequalities across England. It concludes that the DoH was slow to implement cost-effective policy to tackle poor health in the most deprived areas.

It recommends a revised set of QOF indicators and payments so that GPs actively target their most at-risk and impoverished patients.

Improvement in the treatment of many diseases has ‘slowed markedly’ because most GPs now achieve close to maximum points in QOF, says the report.

‘GPs can achieve full payment of the additional income available under this framework without covering the entire practice population and as a result the hardest to reach and most in need groups may not be helped,’ says the report.

The DoH has also failed to fully address the shortage of GP numbers in deprived areas, despite the additional 250 APMS ‘Darzi’ centres set up across England.

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