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Independents' Day

QOF evidence doubts lead to gaming

GPs may be more likely to resort to ‘gaming' to achieve QOF points for indicators where they have doubts over the evidence base, researchers suggest

Their study on the impact of the QOF on primary care found GPs were ‘less inclined to comply with all the contract requirements' in QOF areas where they were unconvinced by the evidence underlying the target.

The data, presented at the North American Primary Care Research Group conference in Toronto last week, also detailed GP feelings of resentment at a culture of ‘box-ticking'.

Researcher Dr Nicholas Steel, clinical senior lecturer in primary care at the University of East Anglia, said some GPs described ‘data manipulation to maximise practice income'.

He added: ‘Gaming may be more likely when practitioners doubt evidence for incentives.'

The views, from interviews of GPs working in 12 practices in eastern England, also suggested non-incentivised conditions were being crowded out as GPs had less time to devote to them.

‘Many GPs expressed unease about "box-ticking" care and wanted recognition for individually focused medicine,' the researchers concluded.

But GPC chair Dr Laurence Buckman hit back angrily at what he said was an ‘insult' to general practice.

‘To describe improved care for individual patients as "box- ticking" is an insult to the many thousands of practices that have delivered high quality for their patients.

‘The fact that the range of conditions is no wider is due to the difficulties of measurement and resource limitations. Many of us might have wished to measure quality in a more holistic way, but the Government has shown no wish to support that.'

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