Gary Jones is a member of the Bow Group Health Policy Committee which is chaired by Stuart Carroll, a senior health economist and Policy Analyst. Here they summarise the research paper they have written with Jennifer White for the Bow Group on the Quality and Outcomes Framework (QOF), which is published today and can be downloaded here.
Launching the recent Conservative Draft Health Manifesto, Shadow Health Secretary Andrew Lansley recognised the current problems in the NHS, noting that under Labour, health inequalities have widened and public health problems, such as obesity and alcohol abuse, are increasing at soaring rates. The role of GPs in tackling these problems must not be underestimated. GPs are normally the first point of medical contact within the NHS and they play a vital role in preventive care, which typically involves diagnostic screening and providing advice on how to lead a healthy lifestyle.
A key part of Labour’s vision has been to empower GPs to improve both patient health outcomes and tackle inequalities. One of the key mechanisms for this vision was the Quality and Outcomes Framework (QOF) – a voluntary incentive scheme for GP practices in the UK that rewards doctors based on the quality of care delivered to patients. The QOF was launched in April 2004 and under this framework GPs are rewarded for implementing "good practice" in their surgeries. The framework is designed to remunerate general practices for providing good quality care to their patients and to help fund work to further improve the quality of health care delivered.
In our research published today, we evaluate the progress the QOF has made since its introduction and consider the different ways in which the QOF can be reformed to be more effective. Overall, it is fair to say that the QOF has been a relative success in supporting the drive to increase the standard of care, but there is strong evidence that standards have tailed off in recent years.
We have found that the problems and shortcomings currently informing the QOF are not so much a consequence of its philosophical purpose, but rather the practical elements determining its operational functioning. We believe that a key consideration for policymakers moving forward should be to look at how the QOF can be improved and reformed to better achieve its stated objectives. Although the QOF in itself is not a vote-winner and is unlikely to register on the public’s political radar, it has the potential to facilitate the outcomes-driven health service the public wants to see and in turn is a potentially important piece of the NHS jigsaw.
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