As the NHS faces up to the economic crisis, it is important to understand how the service is currently using resources and where costs can be reduced by doing things differently.

This report considers the Quality and Outcomes Framework (QOF) from the perspective of attempting to answer two crucial questions:

  • Does improved performance in the clinical domain of the QOF lead to reduced hospital costs?
  • Does improved performance in the clinical domain of the QOF lead to a reduction in mortality?

The research makes an important contribution to a number of topical policy initiatives, including the merits of prevention and early intervention and shifting care from secondary settings to primary care.

As we introduce new models of commissioning, such new evidence can help to guide more effective commissioning processes.

Key findings

Our research:

  • shows an association between GPs achieving the QOF indicators and a reduction in hospital costs and lives saved, particularly for stroke care
  • finds that a single point increase in the QOF stroke score, across England, could lead to 2,385 fewer deaths in a year
  • estimates that improvements in primary care for stroke may have reduced secondary costs by £165 million over a four-year period from 2004 to 2008, measured by a 10 per cent increase in the mean practice QOF stroke score
  • finds that attainment of higher QOF scores in one clinical area could reduce hospital costs in other clinical areas.

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