Evidence of net benefit is lacking

doi:10.1136/bmj.39416.414688.BE

BMJ 2007;335:1170 (8 December), doi:10.1136/bmj.39416.414688.BE

Letters

Quality and outcomes framework

Evidence of net benefit is lacking

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

Earlier this year, while on study leave in the UK, we were askedto write a piece on the quality and outcomes framework (QOF).¹The more we read and spoke to general practitioners, the moredispirited we became. The mixture of supportive wisdom and selfrighteous defensive anger in the rapid responses to Heath etal’s article echoes the range of views we heard.² Clearly(to our jaundiced eyes looking down the barrel of a New ZealandQOF in the making) some (often those who had been around a while)had the wisdom and insight to see QOF for what it is—anunfortunate and far reaching ideological experiment based onpay for performance, which has little or no rigorous evidencebase. We would argue that it is a simplistic and flawed system,which skews the value of measurability over meaningfulness (ignoringthat they are often inversely related); an external, top-down. . . [Full text of this article]

Les J Toop, professor, Dee Mangin, senior lecturer

¹ Department of General Practice University of Otago, Christchurch, New Zealand

les.toop@otago.ac.nz

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