TY - JOUR T1 - December Focus JF - British Journal of General Practice JO - Br J Gen Pract SP - 834 LP - 834 DO - 10.3399/bjgp08X376140 VL - 58 IS - 557 AU - David Jewell Y1 - 2008/12/01 UR - http://bjgp.org/content/58/557/834.abstract N2 - The quest for higher standards in primary care is as old as the practice of medicine, and it's a fair bet that it will continue as long as there are professionals practising. The difficulty has always been in tying down to a simple formula something so varied and personal. The difficulties of assessing basic competence are reflected in Stuart Murray's account of developing summative assessment (page 894). Interesting that direct observation of consulting turned out to be the most discriminatory element in the assessment. Since 2004 in the UK we have had the QOF, but even with later revisions it describes a tiny part of the medicine that we practise, and leaves out so much. One group working in the Midlands has reported on their attempts to widen the scope of the QOF, using additional data routinely collected by PCTs (page 856). They found little correlation between QOF score and indices of deprivation. Some … ER -