QoF ‘fails to promote access’

The Quality and Outcomes Framework has failed to promote improved access or continuity in general practice, according to a new study.

Researchers from Leicester University compared how many points GP practices scored for patient experience on the QoF with the results of their patient access surveys.

The results, published in this month’s British Journal of General Practice, show little if any correlation between the two.

The researchers looked at the QoF and patient survey results of 224 GP practices in the East Midlands and set out to test two hypotheses.

The first was that practices with more positive access survey findings in 2006-7 would be more likely to have achieved maximum QoF patient experience points in the same year.

The second hypotheses was that practices with maximum QoF patient experience points in 2005-6 would have higher access survey results the following year, having acted on the results of their patient feedback.

However, the research team found that there was no association between QoF points and the access survey findings in 2006-7.

They also found little association between high scores for patient experience in 2005-6 – which required GPs to act on the results of patient feedback – and improved access results the following year.

The only exception was opening hours, for which practices that achieved maximum patient experience points did tend to score more highly in the following year’s access survey.

The researchers concluded that the QoF patient experience indicators were not effective at discriminating between different levels of performance.

The research team, led by Professor Richard Baker, who was chair of the expert advisory group on the patient experience indicators from 2006-8, also concluded that an independent survey that directly investigated patients’ experience of access, coupled to a financial incentive, might be a more effective means of promoting improved access and continuity.

However, the Department of Health’s centrally issued GP Patient Experience Survey, launched this year, has been heavily criticised by GP representatives.

They say the survey has had low response rates and that GPs stand to lose thousands of pounds from the QoF on, in some cases, the views of a handful of patients. Thousands of GPs are currently understood to be appealing against the results.