Incentives to Improve Primary Care in England

In this case study, commissioned for our Tools for Change Symposium in April 2010, UK healthcare leader and researcher David Woodhead examines the Quality and Outcome Framework (QOF), a set of performance objectives linked to the blended remuneration system for primary care providers in England. Before the UK government proposed major changes to the NHS in 2010, one significant difference between Ontario’s LHINs and England’s Primary Care Trusts (PCTs) was that the PCTs established contracts with general practitioners. According to the author, the PCTs view this contract relationship as challenging but potentially beneficial to the health of the local population. The case study concludes that the QOF must be understood in the context of a raft of other health reform initiatives, and that the framework’s effects on tackling inequality, promoting health, reducing the burden on secondary care, and linking to other areas of social policy remain underdeveloped.

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