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Patients get 'bum deal'

23rd November 2007

The British Medical Journal has reported that GP targets are acting to the detriment of patient care.

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New contracts mean that GPs earn an average of £110,000 per year and reward doctors with a bonus for reaching particular targets.

Since the start of the new contract in 2004, a third of a GP's salary has been associated with these targets as part of the quality and outcomes framework (QOF).

The majority of the rest of a doctor's salary is comprised of the "global sum", which acts like a basic salary. On average, over 90% of the targets have been met by family doctors.

A group of experts, led by Dr Iona Heath, a GP at London's Caversham Group Practice, said the targets had lessened "the responsibility of doctors to think".

The group said family doctors' new priorities were to ensure "points [were] scored, thresholds [were] met and income [was] generated" - which could compromise standards of care.

The experts said that 75% of people in the UK did not have the conditions specified by the contract and that it concentrated too much on treatment rather than outcome.

"Until the increase in process is translated into tangible outcomes...the benefits and cost-effectiveness of the exercise cannot be established," they warned.

Alastair Henderson, deputy director of NHS Employers, which represents trusts, said there was nothing to prove that "QOF has resulted in lower levels of care for any groups of patients, in fact entirely the opposite".


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