Lack of paediatric QOF targets could undermine child health, warn researchers

The exclusion of targets for paediatric healthcare from the QOF could slow down improvements in primary care for children, researchers have warned.

Child health: QOF criticised over lack of child-focused targets
Child health: QOF criticised over lack of child-focused targets

More than 10% of GP consultations are with children, but the QOF 'largely excludes any assessment of care quality for children despite repeated calls for its inclusion', UK and Canadian researchers warned.

Introducing valid new quality indicators for treatment of children in primary care is 'feasible but difficult', according to the research, published in the British Journal of General Practice.

The researchers looked at national guidelines on the care of children in primary care and assessed how many could be translated into valid quality indicators to plug the current gap in the QOF.

Children left out

Although 10.9% of consultations in general practice in the UK are with under-15s, only 1.2% of QOF indicators relate specifically to children.

The researchers drew up 69 potential new indicators based on national guidelines, but only 35 were deemed valid and feasible to introduce by a clinical expert group, and of those, just seven were deemed to based on more than just expert opinion.

The researchers wrote: 'The indicator set that has been developed here reflects professional concerns and existing guidelines. In the UK it would be implementable through computerised audit of existing primary care records, whether or not it was used just as an audit tool or linked to QOF payment by results. So while the indicator set is not perfect, it is a start and improvement is most likely if it is taken up and used.'

GPC deputy chairman Dr Richard Vautrey said: ‘This research has shown how difficult it is to produce good quality indicators and the ones produced have a weak evidence base. They would therefore not be suitable to add in to QOF.’

‘However we need to move away from a narrow focus on QOF as being the only way to recognise quality of care as there are many other ways commissioners could support and fund practice quality development, including through local enhanced services.’

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