QOF and public health priorities don't improve care in ageing

doi:10.1136/bmj.a1403

Published 27 August 2008, doi:10.1136/bmj.a1403
Cite this as: BMJ 2008;337:a1403

Letters

Care and quality indicators

QOF and public health priorities don’t improve care in ageing

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

The influence of the quality and outcomes framework (QOF) inthe general practitioners’ contract cannot be discounted.¹But not everything can appear in the QOF, and if it doesn’tit doesn’t tend to happen.

Urinary incontinence affects 25% of women over 65; 50% of peopleover 80 fall at least once a year, and women have a 50% lifetimerisk of osteoporotic fracture; over 1 million people in theUK currently have dementia—yet none of these appear. Clearlysuch prevalent and debilitating conditions are of major importance,but as they primarily affect older people they haven’tbeen at the forefront of thinking. They don’t lend themselvesto simplistic "metrics" for measurement and so it is too difficultto show that they are being met. Prescription and rationalisationof medicines in older people is another QOF related issue.

Firstly, although iatrogenic illness related to polypharmacyaccounts for many admissions of older . . . [Full text of this article]

David Oliver, senior lecturer, geriatric medicine¹

¹ School of Health and Social Care, University of Reading, Reading RG6 1HY

d.oliver@reading.ac.uk

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Rapid Responses:

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Sadly, what do you expect?: Mark W Couldrick
bmj.com, 28 Aug 2008 [Full text]
Author should think again: Graham Wheatley
bmj.com, 31 Aug 2008 [Full text]
The truth is out there, however inconvenient: David Oliver
bmj.com, 2 Sep 2008 [Full text]
Out where?: Graham Wheatley
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Cross Purposes: David Oliver
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Focus and clarity on using evidence to improve care performance: Graham Wheatley
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