Oxfordshire GP Dr Richard Lehman and Yale University professor Harlan Krumholz say that reducing the lowest QOF target for HbA1c from 7.5% to 7% for 2009/10 incentivises an outdated treatment strategy.

Evidence from the ACCORD and ADVANCE studies suggests that tight glycaemic control in established type-2 diabetes has little benefit and can be harmful, they say.

In addition, pursuing the target could mean patients are transferred Read more »

Here’s what happens when you give so much attention and influence to such a crude instrument.

Following quality measures can make or break a hospital’s reputation, especially if they are being widely advertised. Patients often make health care choices based on whether doctors following quality measures.

However, as these measures are currently constructed, they often ignore the nuance surrounding many cases.

Emergency Read more »

The team from University College London evaluated BP management in 2006 and compared it to management in 2003, a year before the QOF was introduced.

Overall, they found that 53% of women and 52% of men successfully controlled their BP in 2006 compared to 44% of women and 48% of men in 2003.

The arrival of the QOF also increased the prescribing of hypertensive medications.

In 2006, more than 60% of those treated Read more »

The college’s position is set out in its response to the DoH’s consultation on reforming the way indicators in the quality framework (QOF) are reviewed.

It acknowledged that there is, as yet, no evidence to indicate that it is safe and appropriate to remove incentives when there has been a consistent plateauing of achievement. However, it said it welcomed the proposed approach ‘on the whole’.

Clear Read more »

The college’s position is set out in its response to the DoH’s consultation on reforming the way indicators in the quality framework (QOF) are reviewed.

It acknowledged that there is, as yet, no evidence to indicate that it is safe and appropriate to remove incentives when there has been a consistent plateauing of achievement. However, it said it welcomed the proposed approach ‘on the whole’.

Clear Read more »

Public reporting and transparency are frequent buzzwords in this consumer-directed era of patient care.

Bob Wachter wonders why patients aren’t using the data that’s already out there, as a recent study showed that most patients use word-of-mouth when choosing a doctor.

Is it because of technical limitations of websites, or something “more fundamental,” Dr Wachter asks.

I still think it’s the lack of awareness. A Read more »

The chief nursing officer is one of four DoH officials joining the board from within the NHS. The others are medical director Sir Bruce Keogh, England’s CMO Sir Liam Donaldson and David Behan, the department’s director for social care.

The NQB, established in last summer’s Darzi review, will be responsible for monitoring quality within the NHS, and will produce an annual report comparing the English health service Read more »

Pay-for-performance (P4P) is the latest rage among health wonks as to how to improve the health care system.  But does P4P really improve quality?

Mullen, Frank and Rosenthal (2008) hope to answer this question.  One would initially believe that paying physicians to perform certain medically necessary tasks will improve quality.  Further, some P4P involves structural rewards for physician practice EMR.  If a physician installed Read more »