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QOF shows its mettle

New research has provided the strongest indication yet that GPs' impressive performance in the QOF is translating into concrete clinical benefit.

By Daniel Cressey

In separate studies, research-ers found the QOF had driven up prescribing of drugs covered by quality indicators and appeared to be reducing health care inequalities.

An audit of 117 practices in Lothian, Scotland, found prescribing of drugs related to the QOF increased significantly in GMS practices, although not in their PMS counterparts.

Pre-contract, GMS GPs prescribed 6.9 times as many non-QOF drugs as QOF drugs, but afterwards they prescribed only 4.9 times as many.

Study researcher Sean Mac-Bride-Stewart, senior pharmacist at NHS National Services Scotland, said: 'The change in monthly difference between QOF and non-QOF drugs after the introduction of the GMS contract is statistically significant for GMS practices but not PMS.

'The prescribing of drugs either mentioned or implied within the [QOF] has significantly increased compared with other drugs within the first year of its introduction.'

Dr Peter Elliott, a GP in South Woodford and prescribing lead for Redbridge PCT, said: 'There's no doubt that's one of the effects of QOF and it can only be a good thing. Overall if the relevant drugs have increased it should mean people are getting better care.'

He added that the results did not mean PMS practices were performing less well: 'This could mean PMS practices are already doing it. Declaration of interest ­ I work in a PMS practice.'

The research, presented at the Drug Utilisation Research Group's annual scientific meeting in London this week, analysed prescribing at 93 GMS and 24 PMS practices.

A second study of 38 practices in Rotherham post-contract ­ published online by the Journal of Public Health ­ found none of the expected inequalities in CHD care.

Study leader Dr Mark Strong, specialist registrar in public health medicine at Rotherham PCT, said he could not say definitely the QOF had narrowed inequalities, but it was 'one of the possible explanations'.

He added: 'I'd like to think that's true. The QOF has certainly in some practices increased quality of care considerably.'

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