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We don't want admissions targets in QOF

I should like to clarify the headline and initial scope of the article about QOF admissions targets.

This was derived from chapter 4 of our report, where we analyse the ability of the current QOF to deliver meaningful population health gain and, in doing so, suggest one proxy measure might be reduced 'avoidable' hospital admissions.

However, although we do feel the QOF fails to measure many important outcomes for patients, we do not recommend avoidable admissions should be specifically targeted in the framework. Avoidable admissions may be the result of poor quality care, but they may also be the result of accidents or a failure of a patient to adhere to medical advice or treatment, or be symptomatic of wider problems with access and the lack of integration between primary and secondary care.

Crucially, all of these are outside the control of the individual doctor. Any target relating to admissions would therefore distort clinical care and damage professional integrity. Indeed, our wider point regarding the QOF is that even in its current, largely evidence-based, form, there are significant unintended consequences.

James Gubb, Director of the Health Unit, Civitas

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