Care improvements have ‘plateaued’ with GPs’ performance-related pay

A study has found that although GPs are meeting their financial targets, they are not providing better care for diabetic patients.

Researchers at Birmingham University have found that while there were significant improvements in the level of diabetes care in the three years up to the start of the 2004 bonus scheme, which saw salaries double for some GPs, these subsequently tailed off. Under the scheme, the Quality and Outcomes Framework, points are awarded for the management of a number of conditions, including diabetes.

Dr Melanie Calvert, a lecturer in the university’s college of medical and dental sciences, said: “Improvements in care seem to have plateaued since the introduction [of the pay-for-performance initiative]. Targets for practices need to be more challenging if patients are to benefit.”

She added: “There is a risk GPs are focusing on tick boxes to meet targets, but not focusing on other aspects of care.”

A Civitas study last year found that some GPs were putting more effort into treating conditions that attract points, while several calls have already been made for stricter targets.

In the case of diabetes, GPs win points for controlling blood pressure, cholesterol and blood glucose levels. Each point is worth up to £124, which is shared between GPs at the participating practice.

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