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'GP bonus system' questioned

26th January 2011

A team of experts have questioned the value of the GP bonus system after research indicated it has had no real impact on the treatment of high blood pressure.

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Writing in the British Medical Journal, the international team suggested there was no discernible benefit.

But with family doctors paid bonuses over certain performance targets, the British Medical Association said it was too early to judge the merits of the system, which was introduced seven years ago.

Researchers from Nottingham University teamed up with counterparts in America and Canada and analysed the records of half a million patients from before and after the introduction of the bonus system, looking at rates of blood pressure monitoring, control and treatment alongside how many patients ended up getting ill.

Professor Stephen Soumerai from the team said: “The programme’s lack of effect may be explained in part by performance targets that were set too close to existing practice.”

The BMA’s Dr Laurence Buckman said the bonus system was still relatively new.

“Other studies have shown that it has improved care and treatment for people with diabetes and reduced the number of heart attacks and deaths, particularly in deprived areas,” he said.

“We expect the true gains will be seen in the long-term as more evidence becomes available.”

The Department of Health said the Quality and Outcomes Framework and other incentives for GPs were “insufficiently focused on outcomes, including patient experience” and as a result there are plans to reform the current payment system so that GPs are "rewarded appropriately for improving patient outcomes".

 

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