QOF as Trojan horse

doi:10.1136/bmj.b191

Published 21 January 2009, doi:10.1136/bmj.b191
Cite this as: BMJ 2009;338:b191

Letters

Quality and outcomes framework

QOF as Trojan horse

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

I have mistrusted the quality and outcomes framework (QOF) fromthe start, and its true Trojan horse characteristics are becomingincreasingly obvious.¹

Generally, as each target is attained so it is removed fromthe equation and a new one introduced. More clinical and non-clinicalareas are added, but of course no new resources are offeredto meet this ever expanding range of targets.

Furthermore, the latest additions to QOF are no more evidencebased than many of their forerunners. While waiting for goodevidence that routinely using depression scoring questionnairesimproves the overall outcome of primary care patients with depression,we are already being told to carry out follow-up scoring. Forsome reason we are supposed to offer long term reversible contraceptionto all patients who seek contraceptive advice, despite comparativelyhigh rates of dissatisfaction with long acting progesterone-onlycontraceptive implants (Implanon) (less so with the intrauterineprogestogen-only system (IUS)), . . . [Full text of this article]