Case study from Heart Failure Policy Toolkit

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Incentives for GPs to refer people for specialist diagnosis of heart failure

29 September, 2015

The Quality Outcomes Framework (QOF) is an annual incentive programme for GPs in the UK to achieve improvements in certain health indicators. It includes an incentive to improve the specialist diagnosis of HF patients.

QOF indicator NM116 measures the percentage of people with heart failure who have had their diagnosis confirmed by an echocardiogram or specialist assessment within 12 months. This indicator aligns with the National Institute for Health and Care Excellence (NICE) guidance to provide incentives for practices to ensure that all people with heart failure undergo specialist investigation.

The effectiveness of the QOF in improving quality of care for incentivised conditions is modest, with the impact on costs, professional behaviour and patient experience remaining uncertain.

Resources and other practical implications

Further research is needed on how to improve quality of care in across healthcare domains. Healthcare organisations should be cautious of potential adverse effects of incentive schemes.

Links, references and key reading

Gillam S, Niroshan Siriwardena A, Steel N. Pay-for-Performance in the United Kingdom: Impact of the Quality and Outcomes Framework—A Systematic Review. Ann Fam Med 2012; 10(5): 416-68.

https://www.nice.org.uk/standards-and-indicators/qofindicators?categories=3898&page=1

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The Heart Failure Policy Network is an independent, multidisciplinary platform made possible with financial support from AstraZeneca and Roche Diagnostics. The content produced by the Network is not biased toward any specific treatment or therapy. All outputs are guided and endorsed by the Network’s members. All members provide their time for free. The Network is hosted by The Health Policy Partnership .