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Care stagnates in areas left out of QOF

The quality of care for conditions left out of the quality and outcomes framework has stagnated even as it has improved sharply for those that do carry incentives, a study shows.

The research adds to concerns that the QOF may be 'crowding out' conditions which do not carry quality points.

Researchers examined quality of care for chronic conditions for 2003/5, and found 'a lower baseline level of quality and no significant improvement for non-incentivised conditions'.

The study compared asthma and hypertension, both of which carry QOF points, with depression and osteoarthritis, using both electronic and paper records from 18 GP surgeries.

It found that for the six indicators for asthma and hypertension, achievement had gone up from 75% to 91%. For incentives linked to these conditions, performance had also improved from 53% to 64%.

But for depression and osteoarthritis, which started at a lower achievement level to begin with, the level did not increase significantly – from 35% to 36%.

The report's lead author, Dr Nicholas Steel, senior lecturer in primary care at UAE, said: 'Patients with non-incentivised conditions may be at risk of poorer quality care.

'Even if it is argued that they are more difficult to achieve, it is still remarkable that quality did not improve at all for these conditions.'

The research was published in June's British Journal of General Practice.

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