Time to abolish QOF

doi:10.1136/bmj.b1916

Published 12 May 2009, doi:10.1136/bmj.b1916
Cite this as: BMJ 2009;338:b1916

Letters

Blood glucose in type 2 diabetes

Time to abolish QOF

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

Diabetes has become an industry, with a host of jobs ultimatelydependent on the idea that intensive treatment will achievebetter outcomes.¹

I believe that many patients have been overtreated by doctorsand nurses to hit the previous targets of the quality and outcomesframework (QOF). These patients have had severe hypoglycaemicepisodes and gained a lot of weight (that they will probablynever lose). In my experience, many obese patients startinginsulin treatment will progress to morbid obesity, sleep apnoeasyndrome, fatty liver disease, cirrhosis, severe osteoarthritis,and premature death. The new targets are a lot harder and willinevitably lead to more insulin, more hypoglycaemic episodes,more obesity.

That no QOF targets apply to specialist clinics is puzzling.If they did, I suspect that they would not be hit and the enthusiasmfor the QOF would wane.

Observational studies do show a strong association between abnormalblood glucose . . . [Full text of this article]

Ted Willis, general practitioner¹

¹ Brigg, North Lincolnshire

ted.willis@nlpct.nhs.uk