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Financial incentives to improve the quality of primary care in the UK: predicting the consequences of change

Published online by Cambridge University Press:  31 October 2006

Martin Roland ,
Stephen Campbell ,
Nan Bailey ,
Diane Whalley  and
Bonnie Sibbald
Martin Roland
Affiliation:
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Manchester, UK
Stephen Campbell
Affiliation:
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Manchester, UK
Nan Bailey
Affiliation:
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Manchester, UK
Diane Whalley
Affiliation:
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Manchester, UK
Bonnie Sibbald
Affiliation:
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Manchester, UK
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Abstract

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Up to 20% of additional income is being provided to UK general practitioners (GPs) to improve quality of care, through a complex set of quality indicators which relate principally to chronic disease management and organizational aspects of care. Using data from semi-structured interviews with a purposive sample of 20 GPs and responses from 1035 GPs to a questionnaire survey (53% response rate), we describe the initial impact of these incentives. GPs are employing more staff, especially nurses and data entry clerks, and computerizing their clinical records. Patients are more frequently seen in disease-oriented clinics run by nurses. While the health gains associated with the incentives may be realized, GPs predict that there may be unintended consequences, including reduced continuity of care, care fragmentation, neglect of unincentivized conditions, and the risk of damage to their internal motivation.

Keywords

financial incentivesgeneral practitionersprimary carequality of care
Type
Original Article
Information
Primary Health Care Research & Development , Volume 7 , Issue 1 , January 2006 , pp. 18 - 26
Copyright
2006 Arnold