Financial incentives for general practitioners have failed to improve health standards or reduce inequalities, according to new research published by The King’s Fund.
The pay-for-performance scheme for GPs introduced in April 2004, known as the ‘quality and outcomes framework’ (QOF), didn’t improve ill-health prevention or health promotion by GPs, the think tank said. Where local practices were undertaking preventive activities, they usually pre-dated the QOF and weren’t a result of the incentives.
The research did find that QOF had helped to get GP practices to adopt improved approaches to secondary prevention, for example, identifying and detecting illness. But it didn’t provide incentives to improve primary prevention and public health.
And while differences in performance on QOF between the least and most deprived practices have all but disappeared in recent years, this is likely to be because practices in deprived areas have become more organised and better at meeting the requirements of the QOF rather than having significantly improved the health of their populations.
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Anna Dixon, director of policy at The King’s Fund, said: “A great deal of money has been invested in providing GPs with financial incentives through the QOF. It is disappointing that we have not gained greater return on investment so far in terms of health improvement in deprived areas.”
She added: “General practice has an important contribution to make to improve public health. The development of GP commissioning provides an opportunity to improve the current system of incentives to ensure practices take responsibility for population health not just for treatment of the patients in front of them.”
