Patients view paying GPs for performance as 'inappropriate'

Patients view paying GPs for their performance as an 'inappropriate' way of improving general practice, according to research from the University of Manchester.

Professor Lester: ‘The majority thought paying for performance was an inappropriate quality improvement tool.’
Professor Lester: ‘The majority thought paying for performance was an inappropriate quality improvement tool.’

The study interviewed 52 patients with a mean age of 64, all of whom were on 13 chronic disease registers at 15 QOF pilot practices.

Helen Lester, professor of primary care at the health sciences group at the University of Manchester, said none of the patients had heard of the QOF. 

Patients were not happy at the idea of GPs being paid for meeting targets.

‘The majority thought paying for performance was an inappropriate quality improvement tool.’

‘We heard things like "It’s part of their job",’ said Professor Lester, who is also  the chairwoman of the RCGP’s Clincial and Innovation Research Centre.

Some patients believed that punishment of poorly performing doctors would be a more effective means of driving up the quality of care.

‘Eight people thought GPs should be penalised for poor quality and there should be a disciplinary procedure,’ said Professor Lester.

She said that patients were concerned that by incentivising some aspects of care GPs might ignore the areas that did not carry a financial inducement.

Patients were also puzzled by the aspects of care that had attracted an inducement.

‘They were surprised that practices were paid money for doing what they saw as simple tasks.

‘There was a feeling that if there was going to be financial inducement then it should be for more complex task like minor surgery,’ said Professor Lester.

All of the patients interviewed had been diagnosed before QOF was introduced in 2004.

Three quarters of them had noticed no changes in their care since the QOF had been implemented.

The 25% who had noticed a difference reported that they were being called into the surgery more often.

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