GPs have claimed allowing primary care trusts to draw up their own indicators under the quality and outcomes framework would result in a postcode lottery for patients and damage work on health inequalities.

The British Medical Association's GPs committee, in its response to the Department of Health's consultation on reforms to the framework, said localising the QOF "will be seriously detrimental to the already reduced gap in health inequalities" that its introduction achieved and may threaten consistency of care.

The committee said the proposed changes, which also include handing over the scheme to the National Institute for Health and Clinical Excellence, could lead to it being "inappropriately influenced by political imperatives".

The committee stressed the importance of a UK-wide, evidence-based QOF to maintain its status as a world leader in primary care quality standards.

Regional variations

It said: "It is concerning that NICE, a body primarily set up to ensure an end to postcode prescribing and health authority rationing of healthcare, is to be mandated to provide guidance which will actually inform and support the regional variation of healthcare."

And committee chair Laurence Buckman warned that although the consultation related to England only, the proposed changes would have an impact on the framework "across the UK".

"As it stands, the changes proposed in this consultation will create rather than get rid of health inequalities," he said.