The abbreviation ‘QOF’ refers to the Quality and Outcomes Framework, which is the national system of awarding points to your general practitioner (GP) in the UK.
The points are an extra financial inducement (that is paid from your taxes) to your GP, on top of an average salary of £106,000 per annum, that is paid to GP’s. The average salary for a General Practitioner was reported by the BBC on November 29th 2006. [1]
Every QOF point is worth approximately £120 per point earned, as reported by the BBC, [2] and there are 1050 points [3] available to all GP practices. These points represent an additional payment (potentially) to the GP practice of a further staggering £126,000 per annum.
The GP practice will automatically earn the points for every government target that is met and has a QOF point attached to it. With an additional sum of money of £20,000 more than the GP’s average baseline salary on offer to the GP’s, who are already earning six figure salaries, it is not surprising to find that your GP wants you to be taking statins.
The best thing about taking statins, from your GP’s point of view, is that you will have to be medicated for life once the GP has determined that you fit the criteria for being medicated.
With the latest guidelines calling for a lowering of the underlying levels of cholesterol, you can be sure that you will fit the profile for medication quite soon, even if you do not fit the current government profile for treatment.
It is little short of disgraceful that the UK government sees fit to take from those that have too little (you and me) and give it to those who have far too much. (your GP) The average points achievement across all general practices was 1010.5 which represents an average extra payment to your GP’s practice of £121,260! [4]
Simple arithmetic is all that is required to demonstrate that the average single-handed GP’s annual salary is going be in the region of a whopping £227,260 provided that they have conformed to all of the average norms.
Given this very generous level of salary, you will probably find it much easier to understand why your family doctor wants you to take statins.
Not all of the available QOF points represent the clinical domain within which statins are used. That particular clinical domain is represented by a total available QOF point score of 550. The average achievement for GP’s practices was 534.2 QOF [5] points, which represents an income addition of £64,104.
It is a substantial sum of money and clearly, it would be a great loss to any GP’s practice. The incentive is to prescribe statins regardless of any other issues that may raise.
One further incentive is that the QOF targets are now included as an integral part of the GP’s work contract [6] and the pressure is on the GP to adhere to the terms of the contract of employment. A GP will probably find it very difficult to get defended by any of the medical defence unions, especially where they become liable to an action brought by a patient, if they have not followed the NICE guidelines.
The loop is completed and there is no realistic possibility that the GP will be permitted to exercise their own independent clinical judgement, in cases where the NICE guidelines have dictated otherwise.
The threat of losing £64,104 from one’s annual salary, is a very powerful incentive for your family medical practitioner to toe the government line. It would be unreasonable to expect your GP to reject such a large sum of money, in favour of supporting your own good health.
The following links are referenced (in the text above) by the superscript number between square brackets [1] The National Statin Policy links all begin at the front page and the page number, in the link, is only used to remind you which page you need to look at.
Text ref: [1]
Average pay for GP's
Text ref: [2]
QOF points are worth £120 each
Text ref: [3, 4, 5 & 6]
Link page ref: (page - 22, 23 & 26)
National Statin Policy
