SynthesisBMJ open quality2021
What drives general practitioners in the UK to improve the quality of care? A systematic literature review.
Synthesis in BMJ open quality, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 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
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- General practice incentives: a review of the international literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Pooled it
- The impact of primary care funding on health inequalities: an umbrella review.Primary health care research & development · 2025Pooled it
- Barriers and facilitators to clinical behaviour change by primary care practitioners: a theory-informed systematic review of reviews using the Theoretical Domains Framework and Behaviour Change Wheel.Systematic reviews · 2022Pooled it
- Enhancing System Empathy Within a UK Emergency Department: A Feasibility Interprofessional Priority Setting Exercise.Journal of evaluation in clinical practice · 2026Article
- Jess's Rule: advocating for continuity, ownership, and generalism in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Chronic care provision in general practices and association with patient level outcomes: a nationwide cohort study.BMC medicine · 2025Article
- Does asthma pay-for-performance program really improve the quality of asthma care: a nationwide retrospective cohort analysis in Taiwan.BMC pulmonary medicine · 2025Article
- The impact of wage structure and ability on the incentives for practitioners to engage in primary care in China: a mathematical analysis based on the incentive mechanism of heterogeneous practitioners and tripartite evolutionary game.Frontiers in public health · 2025Article
- Information provision and financial incentives in Catalonia's public primary care (2010-2019): an interrupted time series analysis.The Lancet regional health. Europe · 2024Article
- Weight control efforts and practices and health professional advice: a cross-sectional national survey in England.BMJ open · 2024Article
- The 'STRICT' framework for promoting effective malaria control in Ghana.Malaria journal · 2024Article
- The Impact of Hospital Competition on the Quality of Care in Europe: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Can we measure whether asthma guidelines lead to improved care?NPJ primary care respiratory medicine · 2024Review
- The decline in relationship continuity in England: can a European perspective help?The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- General practitioner preferences for telehealth consultations in Australia: a pilot survey and discrete choice experiment.Primary health care research & development · 2024Article
- Impact of reimbursement systems on patient care - a systematic review of systematic reviews.Health economics review · 2024Review
- Access to automated comparative feedback reports in primary care - a study of intensity of use and relationship with clinical performance among Swedish primary care practices.BMC health services research · 2024Article
- Article
- Telemedicine in the post-COVID era: balancing accessibility, equity, and sustainability in primary healthcare.Frontiers in digital health · 2024Article
- Prevalence of cardiovascular drug-related adverse drug reactions consultations in UK primary care: A cross-sectional study.PloS one · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the UK, the National Health Service has various incentivisation schemes in place to improve the provision of high-quality care. The Quality Outcomes Framework (QOF) and other Pay for Performance (P4P) schemes are incentive frameworks that focus on meeting predetermined clinical outcomes. However, the ability of these schemes to meet their aims is debated.
objectives(1) To explore current incentive schemes available in general practice in the UK, their impact and effectiveness in improving quality of care and (2) To identify other types of incentives discussed in the literature.
methodsThis systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched: Cochrane, PubMed, National Institute for Health and Care Excellence Evidence, Health Management Information Consortium, Embase and Health Management. Articles were screened according to the selection criteria, evaluated against critical appraisal checklists and categorised into themes.
results35 articles were included from an initial search result of 22087. Articles were categorised into the following three overarching themes: financial incentives, non-financial incentives and competition. DISCUSSION: The majority of the literature focused on QOF. Its positive effects included reduced mortality rates, better data recording and improved sociodemographic inequalities. However, limitations involved decreased quality of care in non-incentivised activities, poor patient experiences due to tick-box exercises and increased pressure to meet non-specific targets. Findings surrounding competition were mixed, with limited evidence found on the use of non-financial incentives in primary care.
conclusionCurrent research looks extensively into financial incentives, however, we propose more research into the effects of intrinsic motivation alongside existing P4P schemes to enhance motivation and improve quality of care.
Indexed as
Identifiers
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.