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Financial incentive scheme “reducing inequality gap”

12 August 2008

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Inequalities in the delivery of NHS services between rich and poor areas have been reduced through the introduction of financial incentives for general practices in England, according to a study of the initiative.

The quality and outcomes framework sees general practices in the UK paid for their performance against a set of quality indicators.

Dr Tim Doran, of the National Primary Care Research and Development Centre, University of Manchester, investigated the relationship between socioeconomic inequalities and the delivered quality of clinical care in the first three years of the scheme, from 2004 to 2007.

According to a study, published in The Lancet, most practices in a trial of the scheme reported high levels of achievement for its clinical indicators, with levels increasing most years for most indicators.

The authors conclude: “More than 60% of the gap in life expectancy between the fifth of areas with the greatest material deprivation and poorest health in England and the rest of the country is attributable to diseases targeted in the incentive scheme, particularly coronary heart diseases, cancer and chronic obstructive airways disease.

“Generation of more equitable provision of prevention and care for these disorders means that the use of financial incentives seems to have the potential to make a substantial contribution to the reduction of health inequalities.”

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University of Manchester