What about the impact on patient health?

doi:10.1136/bmj.39269.437176.DE

BMJ 2007;335:60 (14 July), doi:10.1136/bmj.39269.437176.DE

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Financial incentives and GPs

What about the impact on patient health?

The first 150 words of the full text of this article appear below.

McDonald et al's report of general practitioners' and nurses'views of the quality and outcomes framework (QOF) highlightsthe "box ticking" nature of this pay-for-performance contract.¹We have therefore proposed that incentives are linked more directlyto positive health outcomes.

Rotherham practices achieved highly on the smoking related QOFindicators in both 2005 and 2006, costing the primary care trust(PCT), which has a population of 250 000, about £276 000in 2005 and £500 000 in 2006. Despite this, the smokingprevalence among those on Rotherham's QOF chronic disease registersremained essentially unchanged.

We have proposed to the PCT executive and the local medicalcommittee that the QOF contract be renegotiated. We suggestedfor the smoking related indicators that the four week quit targetset for us as a PCT is allocated proportionally between practices;then, at year end, practices are rewarded a proportion of the68 QOF points . . . [Full text of this article]

Mark Strong, clinical lecturer, John Radford, director of public health

Rotherham Primary Care Trust, Rotherham S66 1YY

m.strong@nhs.net

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