The Billion Pound Database

There is a lot of discussion in the media about the increased income of GPs with even Mrs Hewitt wading into the debate. Once you get past the headline figures and the fact that a good part of the increase goes straight back to HMG as increased pension contributions you are left with the QOF income. If there was one condition which came with the investment in the NHS during Labour's second term it was that there should be verifiable results. These were always difficult to find for general practice and so the QOF was formed. Payment for the QOF follows sending in the statistics. Its is these numbers which receive payment and most practices have put in quite a lot of work to get them right. I have sat in innumerable meetings discussing discussing how things should be coded, spent many hours going back through records to make them visible to QMAS, performed over a dozen practice visits and have been on the receiving end of a couple. All of this takes time and I, in common with most of the UK population, don't work for nothing. Most of the work requires a reasonable amount of clinical knowledge so can be difficult to delegate. Like many GPs I am self employed - I don't have a salary for my work, I have profits. The government has decided to pay for statistics. Many GPs have spent hours polishing those statistics to a high shine for inspection and assessment. It is no surprise that profits have risen. The bigger question of the effect on clinical care is more difficult to assess as, almost by definition, there was not much data before QOF. What data there is greatly affected by the lack of incentive to code things. The only direct comparison that I have found is an audit of diabetes which shows some improvement but the effect is not terribly dramatic. In the end what the government really wanted was the statistics and they got them. So can you either browsing this site or downloading the billion pound database.

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