ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Performance of small general practices under the UK's Quality and Outcomes Framework.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- The impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: results from a rapid scoping review.BMC primary care · 2025Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- Small practice participation and performance in Medicare accountable care organizations.The American journal of managed care · 2022Article
- Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Chronic morbidity, deprivation and primary medical care spending in England in 2015-16: a cross-sectional spatial analysis.BMC medicine · 2018Article
- Is the distribution of care quality provided under pay-for-performance equitable? Evidence from the Advancing Quality programme in England.International journal for equity in health · 2016Article
- Withdrawing performance indicators: retrospective analysis of general practice performance under UK Quality and Outcomes Framework.BMJ (Clinical research ed.) · 2014Article
- Article
- Pay-for-performance: impact on diabetes.Current diabetes reports · 2013Article
- Combining QOF data with the care bundle approach may provide a more meaningful measure of quality in general practice.BMC health services research · 2012Article
- Family doctor responses to changes in incentives for influenza immunization under the U.K. Quality and Outcomes Framework pay-for-performance scheme.Health services research · 2012Article
- Health inequalities affect the health of all.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Quality and Outcomes Framework: time to take stock.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundSmall general practices are often perceived to provide worse care than larger practices.
aimTo describe the comparative performance of small practices on the UK's pay-for-performance scheme, the Quality and Outcomes Framework. DESIGN OF STUDY: Longitudinal analysis (2004-2005 to 2006-2007) of quality scores for 48 clinical activities.
settingFamily practices in England (n = 7502).
methodComparison of performance of practices by list size, in terms of points scored in the pay-for-performance scheme, reported achievement rates, and population achievement rates (which allow for patients excluded from the scheme).
resultsIn the first year of the pay-for-performance scheme, the smallest practices (those with fewer than 2000 patients) had the lowest median reported achievement rates, achieving the clinical targets for 83.8% of eligible patients. Performance generally improved for practices of all sizes over time, but the smallest practices improved at the fastest rate, and by year 3 had the highest median reported achievement rates (91.5%). This improvement was not achieved by additional exception reporting. There was more variation in performance among small practices than larger ones: practices with fewer than 3000 patients (20.1% of all practices in year 3), represented 46.7% of the highest-achieving 5% of practices and 45.1% of the lowest-achieving 5% of practices.
conclusionSmall practices were represented among both the best and the worst practices in terms of achievement of clinical quality targets. The effect of the pay-for-performance scheme appears to have been to reduce variation in performance, and to reduce the difference between large and small practices.
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