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At the heart of general practice since 1960

Feeling morbid about the QOF

From Dr Chris Manning, chief executive, Primhe

The reductionist morass that

is the QOF continues to demonstrate the true nature of general practice to be a holistic specialism in its own right. Comorbidities are not just, as Dr Laurence Buckman puts it, 'more work for the doctor' (News, 22 February), but

also for the patient – especially if their morbidity or comorbidity is not even included in the QOF.

I could also barely contain myself when I read about QMAS and 'double counting'. Why, of course that is happening; endless measurement in separate and isolated silos is certain to achieve this outcome. Effectiveness returns when people are dealt with as whole and entire beings; indeed, not doing so further increases the work.

The measurements should also derive from the work and the patient's agenda, not just dictate it.

From the tone of recent articles it also seems to me that those organisations that stand for particular issues and disease areas are being held in some sort of contempt by some GPs for doing so, in a 'where will this all end?' questioning frenzy.

Well, it will end when the 'human condition' and its associated psychological issues are levered back into GP consultations, along with the ventricles, pancreases, lungs, kidneys and assorted other

bits and bobs that are the traditional mechanical subjects in which most doctors are trained.

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