Kath Checkland1, Stephen Harrison. 1. Walport Clinical Lecturer in Primary Care, National Primary Care Research and Development Centre, University of Manchester, Manchester, UK. Katherine.H.Checkland@manchester.ac.uk
Abstract
BACKGROUND: In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. AIM: To investigate in detail the impact of the QOF on practice organisation and service delivery. METHODS: Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. RESULTS AND CONCLUSION: A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.
BACKGROUND: In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. AIM: To investigate in detail the impact of the QOF on practice organisation and service delivery. METHODS: Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. RESULTS AND CONCLUSION: A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.
Authors: Helen Lester; Tatum Matharu; Mohammed A Mohammed; David Lester; Rachel Foskett-Tharby Journal: Br J Gen Pract Date: 2013-06 Impact factor: 5.386
Authors: Kate McLintock; Amy M Russell; Sarah L Alderson; Robert West; Allan House; Karen Westerman; Robbie Foy Journal: BMJ Open Date: 2014-08-20 Impact factor: 2.692