'No convincing evidence' QOF helps patients with long-term conditions

Performance-related pay as promoted through the QOF does not improve care of people with long-term conditions and may have a negative impact on patients, researchers have found.

The study, commissioned by NHS England and led by the University of Kent, examined a number of studies assessing how the QOF has affected patient outcomes.

Published in the British Journal of General Practice (BJGP), it concluded there was ‘no convincing evidence’ that the QOF promotes better care and outcomes for people with long-term conditions.

The scheme could in fact have had negative effects on care, it warned, by diverting practices away from care that is not QOF-related and stifling motivation to improve achievement beyond expected levels.

Around 99% of practices in England are part of the QOF, which was introduced 13 years ago in 2004. It accounts for 10-15% of practice income on average – but is due to be phased out, potentially from April 2018.

The GP contract agreement for 2017/18 said that a 'working group' would be examining the future of QOF after April 2018. The QOF is no longer in place in Scotland and practices have not been required to do this work since April 2016.

Long-term conditions care

This latest study said it is unlikely that abolishing the QOF will cause standards to drop significantly – and doing so may allow practices to prioritise other activities, which could lead to better care.

The researchers found the QOF may be associated with some ‘very modest positive effects’ in limited areas, such as slowing the increase in emergency admissions, an increase in consultations in severe mental illness and improving diabetes care

But they found no evidence that the QOF leads to better coordinated care, more holistic care, better encouragement to self-care or improved patient experience or involvement in decisions. It also appeared to have no effect on mortality rates.

The authors said: ‘The QOF is unlikely to advance progress towards the vision of the Five Year Forward View for the care of long-term conditions.

‘To deliver the aims of the Five Year Forward View, the NHS should consider more broadly – beyond what is measured by the QOF – what constitutes high-quality primary care for people with long-term conditions, and consider managing performance on this basis.

‘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.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Woman holding face in pain

Should GPs treat patients presenting with dental problems?

The MDU's Dr Kathryn Leask considers what GPs should do if a patient presents with...

Conservative Party leadership candidate and foreign secretary Liz Truss

Liz Truss vows to resolve GP pension tax crisis if she becomes prime minister

Liz Truss has affirmed her commitment to resolving the GP pensions crisis but has...

Baby receiving a vaccine in their thigh

JCVI advises changes to routine childhood and HPV immunisation schedules

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended a change...

GP consultation

General practice delivering 'up to double the appointments it is paid for'

General practice in England may be delivering as many as double the number of appointments...

Sign outside BMA House

GP suicide sparks calls for measures to protect doctors from spiralling workloads

The government and policymakers must do more to safeguard doctors and NHS staff from...

Talking General Practice logo

Podcast: Living with long COVID

In August we’re bringing you some of the best interviews from series one of the podcast....