ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2014
Increasing the QOF upper payment threshold in general practices in England: impact of implementing government proposals.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 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 removing financial incentives and/or audit and feedback on chlamydia testing in general practice: A cluster randomised controlled trial (ACCEPt-able).PLoS medicine · 2022Trial
- Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol.Implementation science : IS · 2016Trial
- Influence of financial and reputational incentives on primary care performance: a longitudinal study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Observational
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Authors and funding
4 authors.
Funding
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Abstract
backgroundGeneral practices in the UK receive incentive payments for managing patients with selected chronic conditions under the Quality and Outcomes Framework (QOF) scheme. Payments are made when a negotiated threshold percentage of patients receive the appropriate intervention.
aimFrom 2013-2014 in England the Department of Health has proposed that this negotiated threshold is replaced with a value equal to the 75th percentile of national performance to attract maximum payments. This is an investigation of the potential impact of this change on practice income and workload. DESIGN AND
settingAnalysis of 2011-2012 QOF dataset (the latest available) which covers 8123 GP practices and 55.5 million patients in England.
methodThe 75th percentile of performance was calculated for 52 clinical indicators and applied to 2011-2012 performance. Estimations were made of financial and workload impacts on practices, and whether practices with different characteristics would be disproportionately affected.
resultsThe proposed changes will result in an increase in the upper payment threshold of each clinical indicator by a mean of 7.47% (range 2.16-38.87%). If performance remains static practices would lose a mean of 47.68 (0-108.33) QOF points, equivalent to a mean financial change of -£279.60 (-£35 352.50 to +£19 957.78) per practice for these 52 indicators.
conclusionIncreasing the QOF upper payment threshold to the 75th percentile of national performance will, if clinical performance remains static, substantially reduce the mean number of QOF points achieved per practice. However, this translates into only a small mean loss of income per practice.
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