『Local incentives and general practice: what does the evidence show?』のカバーアート

Local incentives and general practice: what does the evidence show?

Local incentives and general practice: what does the evidence show?

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Today, we’re speaking to Matt Conroy. Matt is a PhD fellow at the University of Manchester and also works for NHS Greater Manchester (ICB) as the Head of Primary Care Intelligence. Title of paper: Impact of local enhanced incentive schemes on the performance of general practices within the United Kingdom: a systematic reviewAvailable at: https://doi.org/10.3399/BJGP.2025.0377Most local commissioning bodies in England, known as Integrated Care Boards (ICBs), have developed their own additional local pay-for-performance (P4P) incentive schemes alongside the Quality and Outcomes Framework (QOF). To our knowledge this is the first review to date to summarise existing evidence on the scope and effectiveness of local incentive schemes implemented in general practice in the UK with a focus on the indicators and their alignment with national schemes.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.480 - 00:01:01.140Hi and welcome to BJGP Interviews.I'm Nada Khan and I'm the Senior Research Editor here at the bjgp.Thanks for taking the time today to listen to this podcast.Today we're talking to Matt Conroy.Matt is a PhD fellow based at the University of Manchester and he also works for NHS Greater Manchester ICB as the Head of Primary Care Intelligence.We're here to talk about the paper he's recently published in the bjgp, which is titled the Impact of Local Enhanced Incentive Schemes on the Performance of General Practices within the United A Systematic Review.So, hi, Matt, it's really nice to meet you and to talk about this work and I wonder if, just to start with, if you could explain a bit about what we mean by local incentive schemes in general practice and why you wanted to look at them, and I wonder if you wanted to draw a little bit on your additional role working for the Greater Manchester ICB as well here.Speaker B00:01:01.220 - 00:01:54.400Thanks.I guess by a local deep incentive scheme, we mean something that's kind of locally designed or locally commissioned within a ICB footprint to try and address any particular population health challenges or local nuances that go over and above national policy, things like the Quality and Outcomes Framework.I guess what was really insightful for us through doing this piece of work was actually through an FOI that we undertook.Like 90, 98% of ICBs actually have their own local gene for incentive schemes, but we only identified 17 schemes through the published literature, the last one being from 2018.So getting on for 10 years ago, and the fact that we know that so many ICVs are doing these things, but there's not the evidence body there, there's not the learning and sharing of best practice to really inform policy and help ICVs all try and address their local challenges.Speaker A00:01:55.210 - 00:02:10.650Yeah.And you've mentioned qof and I guess a lot of people are really familiar with qof, and as you mentioned, there are lots of local schemes sitting alongside it.And I wonder if you have an idea of just what sort of things they're trying to incentivize, just from sort of the background to your work.Speaker B00:02:11.210 - 00:04:48.850Yes.So, as part of my day job, I help design and deliver the local GP incentive scheme in Greater Manchester.It's roughly valued about £17 million for this year.And I think what we try to do is use QOF as a bit of a body of evidence, but also look at a lot of our local and national data to really highlight where we think we can make a difference with these local incentive schemes.So, for the 26, 27 financial year, we've done a piece of work to really home in on CBD and diabetes as one area, respiratory as another area, elective care.So we can get the interface between primary and secondary care and also antimicrobial stewardship.I think one of the things that's really fleshed out from that is the impact of non attenders on things like qof.So through qaff, if patients have two or one invites seven days apart, they automatically get exception reported if they don't necessarily attend.But what we found through our local data is actually there's a really strong link between those people and actually poorer CBD control and wide use of healthcare systems.So.So through our local GP insentive scheme, we've really designed almost a narrow cohort that looks at people's individual disease control, looking at things like blood pressure, HbA1c, but also where people haven't attended a review in more than 18 months.So really trying to hone in on specific cohort, acknowledging that those people are really difficult to engage with by proxy.The fact that they've had two invites and not responded.But actually through having a local GP incentive scheme that really highlights these as a specific target cohort group and having dedicated funding alongside it, we can see that from our QOF data, we've had a reduction in exception reporting and ...
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