Date Published: 8 July 2011

Do patients think GPs should be paid for performance?

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NHS patients (in the UK) were surprised to hear that a pay-for-performance scheme rewarded GPs for simple tasks such as recording blood pressure, according to a recent study .

The results and conclusions of the study were presented at the 40th Annual Scientific Meeting of the Society for Academic Primary Care hosted by the University of Bristol's Academic Unit of Primary Health Care, explore patients' views of pay-for-performance in primary care.

Kerin Hannon, Stephen Campbell and Professor Helen Lester of Manchester University (England) asked twenty-six 'QOF pilot' practices across England, representative in terms of size and deprivation, to contact patients on a single QOF (Quality and Outcomes Framework) disease register. 56 patients aged 32- to 90-years (mean age 65) were interviewed from January to March 2011. All had at least one chronic condition that predated QOF. None had heard of QOF and few had noticed changes in their care since 2004. However, the majority of patients were reassured by the use of a computer in their consultation and liked the fact the GP was checking up on health issues unrelated to their presenting complaint. A minority also noted they were now more likely to be called in for a blood test or medication review.

Most patients were surprised to hear that their practice was paid money for 'simple things' such as recording blood pressures and wondered why GPs were paid bonuses (considering their high salaries) or were not paid bonuses for managing more complex issues. Some patients also raised concerna about potential unintended consequences of pay-for-performance such as a reduced focus on non-incentivised areas and a lack of consideration of individual differences in treatment.

Kerin Hannon, Research Associate in Manchester's Health Sciences Research Group, said:

" Most patients trusted and liked their GP and did not feel that a pay-for-performance scheme was necessary to ensure quality of care."

A constant comparative methodology was used to analyse the transcripts. The generalisability of this study is limited by the participants' age and possible respondent bias.

Research Paper:
Patients' views of pay-for-performance in primary care by Kerin Hannon, Stephen Campbell and Professor Helen Lester.

Source:  Bristol University, England (UK)

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