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Cutting QOF cash the wrong approach

The QOF has never been a discriminator of quality.

It is inappropriately named - rather than the quality and outcomes framework, it should be the quantity inputs framework.

The main discriminator in the QOF is prevalence.

High prevalence with high achievement suggests good practice. Any combination of low prevalence or low achievement suggests a closer look is needed to find out why.

If anything, increased payments for the QOF, with wider and more testing indicators and less reliance on the global sum and capitation, is what is needed to drive up quality - unless reducing QOF pay is a way of reducing overall GP remuneration.

Dr Spencer Nicholson, formerly Salford, now working in Australia

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