spotlight

The impact of incentivisation on general medical practice In late 2003 I was a junior partner in a primary care medical practice serving roughly 8000 patients on the south coast of England. General practice had been going through the doldrums, pay was low, morale was low and there was dissatisfaction with the contract with the NHS. (Looking back, the problems pale into insignificance compared with the current situation in UK general practice).The Labour government of the day sought to change that through radical changes to the GP contract with far reaching implications including the removal of 24 hour responsibility for one’s own patients and the introduction of a performance-related element to the remuneration of practices. This latter element was the QoF – the Quality and Outcomes Framework for general practice- which rewarded practices for carrying out a series of process indicators with the aim of reducing unwarranted variation in chronic disease management, business and