Quality and outcomes framework for primary care in the United Kingdom

Added May 11, 2020

Citation: Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: Impact of the quality and outcomes framework – a systematic review. Annals of Family Medicine 2012; 10: 461-8

What is this? The COVID-19 pandemic is placing a strain on healthcare systems and resources. Existing research into the effects of pay-for-performance schemes in primary care, such as the UK Quality and Outcomes Framework (QOF) which was introduced in 2004, might provide useful information for policy makers.

In this systematic review, the authors searched for studies that assessed the impact of the Quality and Outcomes Framework (QOF) on the quality of primary care in the UK. They restricted their searches to articles published in English since 1 January 2004 and did the search in July 2011. They included 94 studies across five areas: effectiveness, efficiency, equity and patient and professional experience.

What was found: There were modest improvements in the quality of care for chronic diseases included in the QOF during the first year of implementation, but these improvements were often not sustained in the long term.

QOF led to modest reductions in mortality and hospital admissions in some areas, which appeared to be cost-effective.

QOF led to narrowing of differences in performance in deprived areas compared with other areas.


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