The quality and outcomes framework of the GMS contract: a quiet evolution for 2006.
Year: 2006
Type: article
Abstract: A new contract for general medical services delivered by general practices was introduced in the UK in April 2004. A Quality and Outcomes Framework (QOF) was an integral part of the new contract and rewarded practices for delivering more evidence-based care. This marked a fundamental shift in the way general practice was resourced with a mixture of capitation, fee for service and performance-related pay.
The QOF has been described both as ‘an initiative to improve the quality of primary care that is the boldest such proposal on this scale ever attempted in the world’1 and also as a threat to the ‘professional basis of general practice, indeed its very existence as a speciality’.2 The division of opinion is reflected in uncertainty whether it has made any difference to patient care.
Theoretically, the introduction of 146 largely evidence-based indicators, 76 in 10 clinical areas, should lead to more consistent care and positive changes in patient-related health outcomes. QOF may have ended personal professional autonomy in some aspects of primary care, with disincentives to offer substandard care or be out of date with clinical opinion. It would, however, be wrong to claim that current improvements in health care are all QOF-related. Substantial improvements occurred in the clinical quality of care for coronary heart disease, diabetes and asthma before its introduction.3 However, there are some early indications from the Quality Management and Analysis System (QMAS) data and from modelling work4 that QOF has continued to encourage improvements to clinical care. QOF may also have created …
Source: Europe PMC (PubMed Central)
Authors: Helen Lester, Deborah J Sharp, F Dr Hobbs, Mayur Lakhani
Institution: University of Birmingham
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1850629699