Editor's Choice

QOF and whistleblowers

BMJ 2009; 338 doi: 10.1136/bmj.b2263 (Published 4 June 2009)
Cite this as: BMJ 2009;338:b2263

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  1. Jane Smith, deputy editor, BMJ
  1. jsmith{at}bmj.com

    This week Chris Ham (doi:10.1136/bmj.b2198) contrasts the UK Conservative party’s reliance on markets to improve performance with the “targets and terror” approach that has driven many of the recent improvements in the NHS. Many readers will like that description—though you probably also share Ham’s (familiar) concerns about the effectiveness of markets for health care.

    Yet not all targets have been accompanied by terror: some have hefty incentives. None more so than the Quality and Outcomes Framework (QOF) in general practice, one of the most ambitious “pay for performance” systems in the world (BMJ 2003;326:457, doi:10.1136/bmj.326.7387.457). So far the verdict has …

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