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Reduce “distorting” cash incentives for doctors, Nuffield Trust says

17 June 2015

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Doctors financial rewards and incentives should be reduced as they “can distort priorities” a Nuffield Trust briefing released today says.

The briefing Transforming general practice: What are the levers for change? alsosaid that the current combination of national and local incentive schemes along with quality and outcomes framework (QOF) risk overwhelming GPs and limits their ability for sustainable change.

Instead money should be invested in equipping organisations to change and making better data available to evaluate the result, the briefing said.

Dr Rebecca Rosen, a senior policy fellow at the Nuffield Trust and the author of the briefing said: “The history of reforming general practice in England is littered with initiatives aimed at achieving small-scale change through financial rewards. These can work well if the goal is to improve narrow areas of care. But they are blunt instruments, which can distort priorities and detract from patient care.

“Putting the Forward View into action will require policymakers to adopt a far more sophisticated approach to reform than the narrow use of financial rewards and contract changes. They need to be supplementing the use of these measures by building skills, understanding impact and creating the headspace that GPs need to fundamentally transform services,” she said.

The briefing draws on academic evidence on the use of financial incentive schemes such as QOF, and other approaches to creating change, as well as expert testimonials and case studies.

“Nobody disputes that there is a pressing need to reform general practice. But the challenges facing GPs – from meeting the needs of frail older people, to working at scale across larger areas – require us to think differently,” Rosen said.

Read the full briefing here