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Evaluation of the introduction of QOF quality improvement modules in English general practice: Early findings from a rapid, qualitative exploration of implementation

Bramwell, Donna, Peckham, Stephen, Hotham, Sarah, Checkland, Kath, Forbes, Lindsay (2022) Evaluation of the introduction of QOF quality improvement modules in English general practice: Early findings from a rapid, qualitative exploration of implementation. BMJ Open Quality, . E-ISSN 2399-6641. (doi:10.1136/bmjoq-2022-001960) (KAR id:96962)

Abstract

Background A 2018 review of the English primary care

pay-for-

performance

scheme, the Quality and Outcomes

Framework, suggested that it should evolve to better

support holistic, patient-centred

care and leadership for

quality improvement (QI). From 2019, as part of the vision

of change, financially incentivised QI cycles (initially in

prescribing safety and end-of-

life

care), were introduced

into the scheme.

Objectives To conduct a rapid evaluation of general

practice staff attitudes, experiences and plans in relation

to the implementation of the first two QI modules. This

study was commissioned by NHS England and will inform

development of the QI programme.

Methods Semistructured telephone interviews were

conducted with 25 practice managers from a range of

practices across England. Interviews were audio recorded

with consent and transcribed verbatim. Anonymised

data were reflexively thematically analysed using the

framework method of analysis to identify common themes

across the interviews.

Results Participants reported broadly favourable views

of incentivised QI, suggesting the prescribing safety

module was easier to implement than the end-of-

life

module. Additional staff time needed and challenges of

reviewing activities with other practices were reported

as concerns. Some highlighted that local flexibility and

influence on subject matter may improve the effectiveness

of QI. Several questioned the choices of topic, recognising

greater need and potential for improving quality of care in

other clinical areas.

Conclusion Practices supported the idea of financial

incentivisation of QI, however, it will be important to ensure

that focus on QI cycles in specific clinical areas does not

have unintended effects. A key issue will be keeping up

momentum with the introduction of new modules each

year which are time consuming to carry

Item Type: Article
DOI/Identification number: 10.1136/bmjoq-2022-001960
Subjects: R Medicine > RZ Other systems of medicine
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Lindsay Forbes
Date Deposited: 16 Sep 2022 18:37 UTC
Last Modified: 04 Jul 2023 13:03 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/96962 (The current URI for this page, for reference purposes)

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