SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2017
The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 6 syntheses or guidelines pooled it, 184 citations in OpenAlex.
- Pooled it
- What drives general practitioners in the UK to improve the quality of care? A systematic literature review.BMJ open quality · 2021Pooled it
- Effects of Monetary Incentives in Physician Groups: A Systematic Review of Reviews.Applied health economics and health policy · 2020Pooled it
- The evidence gap on gendered impacts of performance-based financing among family physicians for chronic disease care: a systematic review reanalysis in contexts of single-payer universal coverage.Human resources for health · 2020Pooled it
- Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Primary health care quality indicators: An umbrella review.PloS one · 2019Pooled it
- The Effect of Financial Incentives on Quality Measures in the Treatment of Diabetes Mellitus: a Randomized Controlled Trial.Journal of general internal medicine · 2022Trial
- Value-Based Pricing of Health Services With Health Equity Considerations.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026Article
- Understanding Remission of Long-Term Conditions Through Electronic Health Records: Scoping Review.Journal of medical Internet research · 2026Article
- Shifting patterns in emergency department attendance: a time series analysis.Emergency medicine journal : EMJ · 2026Article
- Impacts of Social Environments on Neighborhood Depression Incidence: Fully Accounting for Spatial Effects.International journal of environmental research and public health · 2026Article
- Impact of a community-led intervention on the uptake of childhood vaccines in Liverpool: a protocol for a synthetic control evaluation.BMJ open · 2026Article
- Key Indicators of Performance-Based Payment to Physicians by Insurance Organizations in Iran.Medical journal of the Islamic Republic of Iran · 2026Article
- Integrated care for people with multimorbidity into elective surgical pathways: mixed-methods co-design study.The British journal of surgery · 2025Article
- A Pragmatic Approach to Improving Management and Patient Flow for Painful Diabetic Neuropathy in UK Primary Care.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Practitioners' views on the measurement and management of postural hypotension in general practice: a qualitative inquiry.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- How does the quality of outcomes framework impact on the quality of life of adult patients with diabetes? A cross-section study in England using GP Patient Survey data.BMC primary care · 2025Article
- Article
- Chronic care provision in general practices and association with patient level outcomes: a nationwide cohort study.BMC medicine · 2025Article
- An automation framework for clinical codelist development validated with UK data from patients with multiple long-term conditions.BMC medical research methodology · 2025Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproving care for people with long-term conditions is central to NHS policy. It has been suggested that the Quality and Outcomes Framework (QOF), a primary care pay-for-performance scheme that rewards practices for delivering effective interventions in long-term conditions, does not encourage high-quality care for this group of patients.
aimTo examine the evidence that the QOF has improved quality of care for patients with long-term conditions. DESIGN AND
settingThis was a systematic review of research on the effectiveness of the QOF in the UK.
methodThe authors searched electronic databases for peer-reviewed empirical quantitative research studying the effect of the QOF on a broad range of processes and outcomes of care, including coordination and integration of care, holistic and personalised care, self-care, patient experience, physiological and biochemical outcomes, health service utilisation, and mortality. Because the studies were heterogeneous, a narrative synthesis was carried out.
resultsThe authors identified three systematic reviews and five primary research studies that met the inclusion criteria. The QOF was associated with a modest slowing of both the increase in emergency admissions and the increase in consultations in severe mental illness (SMI), and modest improvements in diabetes care. The nature of the evidence means that the authors cannot be sure that any of these associations is causal. No clear effect on mortality was found. The authors found no evidence that the QOF influences integration or coordination of care, holistic care, self-care, or patient experience.
conclusionThe NHS should consider more broadly what constitutes high-quality primary care for people with long-term conditions, and consider other ways of motivating primary care to deliver it.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.