The GP incentive scheme has not had the dramatic impact on diabetes care that was predicted when it was introduced five years ago, researchers have found.

Researchers at the University of Birmingham found that while care for diabetes patients had improved, there was “little evidence to suggest that this is a direct result of the [Quality and Outcomes Framework] performance-related-pay initiative”.

Study leader Melanie Calvert said: “The management of patients with diabetes has improved, but the introduction of QOF may not be responsible.

“If anything improvements in care appear to have plateaued since the introduction of the QOF.

“This may reflect increasing difficulties in target attainments in poorly controlled patients, but could also suggest that targets for practices need to be more challenging if patients are to benefit.”

Dr Calvert said her work had also highlighted that “a large number of patients in whom care may be suboptimal” may not be covered by assessments for the framework.

“This needs to be addressed to reduce health inequalities,” she said, adding that GPs could be focusing on hitting framework targets at the cost of the quality of care offered to patients.