Views & Reviews From the Frontline

The end of targets?

BMJ 2010; 341 doi: (Published 07 July 2010) Cite this as: BMJ 2010;341:c3619
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

    In the past there was significant variation in clinical practice and access to general practice. Then came the quality and outcomes framework (QOF), which promoted “evidence” based management of chronic diseases through a thousand target points. At the same time the “advanced access” initiative was launched, committing us to enable access to primary care within 48 hours. These targets were robustly based on evidence to improve “quality,” access, and choice. And unlike many other public sector initiatives their effects were felt across the whole of society because few opt out of state …

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