Intended for healthcare professionals


GP incentive scheme has had little effect on health inequalities in England

BMJ 2011; 342 doi: (Published 20 April 2011) Cite this as: BMJ 2011;342:d2536
  1. Anne Gulland
  1. 1London

The incentive scheme for GPs in England, the Quality and Outcomes Framework (QOF), has failed to lead to better health promotion in deprived areas, research has shown.

The study, which was carried out by the health think tank the King’s Fund and the London School of Hygiene and Tropical Medicine and was based on an analysis of qualitative data and interviews, found that the framework has “promoted a medicalised and mechanistic approach to managing chronic disease which does not support holistic, patient-centred care or promote self care and self management.”

QOF, introduced in 2004, rewards GPs for meeting a range of quality targets, such as on managing coronary heart disease, heart failure, and hypertension; cervical screening; and surveillance of child health. The study acknowledges that reducing …

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