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In August 2007, NHS Employers and the BMA’s General Practitioners Committee completed the evidence-gathering phase for the further development of the quality and outcomes framework (QOF). Patient groups, national societies, and individual GPs provided their views about current and new indicators, and a total of 153 submissions were received.

With negotiations around the QOF revisions ongoing, the potential changes to the indicators have been the subject of a number of recent journal and news articles. For example:

• an article in the BMJ1 highlights the effectiveness of the QOF in relation to the management of CVD, and shows how practices can earn many points without necessarily reducing its risk. An accompanying editorial states that the QOF review is a good opportunity to ensure that payments are directly linked to treatment and prevention rather than the process itself
• The Blue Book2 (see article), which outlines best practice for the management of osteoporosis and fractures, identifies a key role for primary care. The report states that: ‘Currently, structures and incentives do not support the potential contribution of the primary care team in the management of osteoporosis,’ and presses for the inclusion of osteoporosis in the QOF.

The revisions to the GMS contract and QOF are awaited with interest, and what they mean to everyday practice will be the focus of future articles in the Guidelines in Practice GMS contract series.

Julia Morris, Editor
julia.morris@mgp.ltd.uk

1. Guthrie B, Inkster M, Fahey T. Tackling therapeutic inertia: role of treatment data in quality indicators. Br Med J 335 (7619): 542–544.
2. British Orthopaedic Society, British Geriatrics Society. The care of patients with fragility fracture. London: BOA/BGS, 2007.G