No, the story of the precursors to QOF has not been well told despite the assertion by Ashworth and Kordowicz.1
QOF did not appear out of thin air but was the end result of initiatives in Scotland and especially east Kent. Rowland2 does not give enough recognition to this work despite having published a paper with Spooner and Chapple describing the work done in east Kent from 1998 in the PRImary Care Clinical Effectiveness Programme (PRICCE).3
PRICCE was the initiative of Dr A Snell of East Kent Health Authority, supported by Dr A Coulson, chairman of East Kent Local Medical Committee, and Dr R Pinnock, chairman of East Kent Medical Audit Advisory Group. The chief executive of the East Kent Health Authority, Mr M Outhwaite, made available £1 000 000 for funding. The initiative focused on the management of chronic disease.
In PRICCE 1, 14 disease areas were identified including asthma, hypertension, atrial fibrillation, hypercholesterolaemia, and among others, diabetes. In PRICCE 2, a further nine areas were introduced including palliative care management, colorectal cancer, anxiolitics in older people, and COPD.
Spooner, Chapple, and Rowland3 concluded ‘when managerial vision is aligned to professional values, and combined with a range of interventions known to have influenced professional behaviour including financial incentives, substantial changes in clinical practice can result. Lessons are drawn for future quality improvement in the NHS’.
Mr M Farrar, chairman of the NHS Confederation Negotiating Team (now CEO NHS north west [SHA]) said:
PRICCE practices have shown that where effort is targeted they have met with considerable and sometimes unexpected success. This has demonstrated that it is unwise to underestimate what is possible. I commend this project to you as a good working example of how to implement the Quality and Outcome Framework of the GMS2 contract.
I suggest it is time recognition was given where it is due.
- © British Journal of General Practice, 2010.