Exclusive: Half of UK GPs unsure of QOF

UK GPs are more split on whether financial incentives based on achieving healthcare targets are a good idea than GPs in the rest of Europe, according to a survey.

A total of 399 GPs from France, the UK, Italy, Germany and Spain took part in a poll carried out by researchers Stethos for the French general practice magazine Le Generaliste. The results show that 26.6 per cent of UK GPs were undecided about the value of incentives such as the GMS quality framework, beating Germany to second place with 25.3 per cent unsure there.

A total of 24.1 per cent of UK GPs thought financial incentives a bad idea and 49.4 per cent backed them.

The UK is the only country of the five polled to have financial incentives, in the form of the quality framework, in place. Germany is considering this approach. Most French GPs rejected the idea (55.6 per cent) while the Spanish and Italians were in favour of it (57.5 and 70 per cent respectively).

GPC deputy chairman Dr Richard Vautrey said that it was difficult to speculate on the results but he suspected many UK GPs remained uncomfortable with the quality framework.

'There's still a sense that a per-formance validated pay scheme does not sit well with medicine and especially the holistic nature of being a GP,' he said.

Many feel that things like the quality framework are not sensitive enough to the type of care that is really valued by patients, such as helping them through a family crisis. These are the areas that are difficult to reward'.

Professor Alan Maynard, a health economist at York University said the uncertainty over financial incentives among German and UK GPs reflected moves in both countries.

German GPs are paid on a fee-for-service basis but the German government is attempting to incentivise practices to work together in groups to provide chronic disease care. Many German doctors regard this as a threat to their way of working, Professor Maynard said.

'The UK response is probably due to fears over the future. Whilst many are happy with the way the quality framework is now working, the worry is that the government will try to change the goal posts or the payments for the quality framework,' he added.

Professor Maynard said that as long as the quality framework remained evidence based then it was clear it was a very successful tool for changing GP behaviour in long-term conditions.

The future of the quality framework in the new GMS contract in the UK is currently under discussion by negotiators.

Full details of the survey results are to be revealed later this month at the World Organisation of Family Doctors (WONCA) Congress in Paris, France.

What do you think of financial incentives for health outcomes? Write to GPletters@haymarket.com.

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