The government's culture of targets is undermining the relationship between GPs and patients, which has always been based on trust and professional integrity, according to a new report.
The report from the think-tank Civitas – Checking-up on Doctors – examines the Quality and Outcomes Framework (QOF), currently out for consultation by the Department of Health.
Authors James Gubb, director of the Civitas Health Unit, and Grace Li, accuse the framework of offering inappropriate financial incentives that can distract GPs from providing high-quality personalised care for patients.
They call for the QOF, which links up to a third of general practice income to performance against a range of quality indicators, to be "downsized and downscaled sooner rather than later".
The report says that the framework is open to abuse, adding: "Some practices have artificially boosted QOF scores by inappropriately excluding patients or adjusting the reported prevalence of disease."
James Gubb commented: "Medicine is an inexact science. In encouraging more of a 'medicine-by-numbers' approach, there is a real risk that in the long-run the QOF could inadvertently cause a decline in general practice's ability to probe symptoms, explore probabilities and give proper attention to the concerns of patients."
Copyright © Press Association 2008
Do you agree with Civitas' argument? Your comments: (Terms and conditions apply)
"No – at last patients can know what to expect. PCTs will spot 'radar' numbers, GPs will never give up their personal management of their patients. They have been around a lot longer than the QOF" – Carl Curtis, Southwark
"I certainly do and it affects the nurses just as much as the GPs, with pressure on the nurses to tick all the boxes and complete things to enhance the QOF figures for more money. Rock and hard place!!" – Chris B, Sussex