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30-01-2011 | General practice | Article

Local QOFs urged

Abstract

BMJ 2011; 342: c7805

GP consortia should develop local Quality and Outcomes Framework (QOF) performance targets, experts say.

Writing in an article in the BMJ, they say their experience has shown that local incentives can help focus attention on local health needs.

Researchers including Azeem Majeed, a GP and professor of primary care at Imperial College London, explain that a previous recommendation to devolve some of the QOF budget to local areas was controversial and has not been widely implemented.

But they argue that this approach allows more ambitious targets to be set according to local health needs and may provide an effective way to deliver interventions aimed at reducing health inequalities.

A few primary care trusts have adopted local QOF, the largest being the QOF+ programme running in the London borough of Hammersmith and Fulham, costing £2.2 million per year. A key aim of QOF+ was to improve indicators of poor health in the borough, such as high rates of smoking and tuberculosis. The scheme provides additional financial incentives for achieving treatment thresholds set higher than those in the national QOF.

Dr Majeed and colleagues write: "Our experience suggests that current reluctance to set up local incentive schemes may result in missed opportunities to improve quality, encourage innovative service development and tackle local health priorities."

However, the team says, such schemes require considerable resources, a robust IT infrastructure and a national menu of quality indicators for local use.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price