Posts Tagged qof

An addendum: ‘Quality’ Often Flawed

Just to support the point being made on this blog yesterday, today the British Medical Journal runs this in their editorial:

‘One problem with implementing evidence based medicine is, of course, that the evidence keeps changing. An important recent example is the mounting evidence that ever tighter glucose control in people with type 2 diabetes may actually be harmful. As Richard Lehman and Harlan Krumholz point out in their editorial (doi:10.1136/bmj.b800), the evidence that tighter control might not be better was emerging just as the targets for the 2009 quality and outcomes framework (QOF) were being re-negotiated. The framework sets evidence based clinical targets for British general practices to reach (and pays them for doing so), and it has helped improve the implementation of evidence based interventions. But the 2009 version now includes a tighter target for glycated haemoglobin—just as that looks to be the wrong thing to be doing.’

Oh dear.

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Exception reporting… again

A few weeks ago the DH released the conclusions of its consultation on the Quality and Outcomes Framework in general practice – a series of clinical guidelines GPs are expected to meet that is linked to c.20 per cent of their income.  Predictably, the responsibility for its evidence-base is being turned over to NICE: a risk.
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Government targets distorting GP/patient relationship?

The Quality and Outcomes Framework (QOF) has lofty aims. In linking up to a third of general practice income to achievement against a series of quality indicators, it hoped to deliver significant increases in quality to patients. Has it succeeded?

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The other side of the QOF

The Quality and Outcomes Framework (QOF) – the framework that offers GPs financial incentives for meeting certain standards of care – has been accredited with improving clinical quality across general practice and cutting health inequalities for certain core diseases. But, as ever, we should be concerned with unintended consequences.
Continued at bmj.com.

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