Quality in primary care
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Since its inception in 2004 the Quality and Outcomes Framework (QOF) has become embedded in the fabric of day-to-day general practice. Yet despite some of its tangible successes, the QOF's vulnerability to gaming poses challenges to its applicability as the dominant quality improvement framework in primary care. This paper questions whether high QOF scores amount to better care or simply the illusory effects of better data recording. Suggestions for developing QOF are made in the light of its limitations as a public health improvement initiative.
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Quality in primary care · Jan 2010
An international perspective on the basis for payment for performance.
This discussion paper reflects on the pay-for-performance system in UK general practice - the Quality and Outcomes Framework (QOF) - from an international viewpoint. The QOF intends to bring the best scientific evidence to bear on primary care practice. However, the QOF and patient-centred medicine are often at odds. ⋯ The extent of impact of the QOF on health outcomes and on equity of health outcomes needs examination. Attention to resolution of patients' problems is an important aim of quality improvement activities. Alternative modes of improving patient care may be better than the QOF.