QOF creates incentives for embellishment and puts substantial demands on primary care

As a UK general practitioner (GP) in 2002, when the Quality and Outcomes Framework (QOF) was introduced, I anticipated that it would enhance quality of care by incentivising structured chronic disease management. But Ho and colleagues’ systematic review aligns with my experience that its impact on care quality has been limited.1

The observed short term improvements in quality, often reversed when the incentive was …