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Qual Prim Care. 2010;18(2):139-46.

The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

Author information

1
Walport Clinical Lecturer in Primary Care, National Primary Care Research and Development Centre, University of Manchester, Manchester, UK. Katherine.H.Checkland@manchester.ac.uk

Abstract

BACKGROUND:

In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards.

AIM:

To investigate in detail the impact of the QOF on practice organisation and service delivery.

METHODS:

Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices.

RESULTS AND CONCLUSION:

A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

PMID:
20529476
[Indexed for MEDLINE]

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