The quality and outcomes framework has reduced the link between low-income areas and poor primary healthcare, a study suggests.

Performance against QOF indicators increased by 4.4 per cent for general practices in the wealthiest areas but by 7.6 per cent in the poorest. This narrowed the gap in achievement between the wealthiest and poorest areas from 4 per cent to 0.8 per cent.

Manchester University's national primary care research and development centre analysed performance between 2004-05, when the new GP contract was introduced, linking income to the indicators, and 2006-07.

By the third year factors such as population age and sex profile were more strongly linked to achievement than area deprivation, according to the report, published in The Lancet. Lead author Tim Doran said: "What was surprising was the variation came down so quickly, over just three years."

He added it was possible activities not included in the framework had suffered while GPs focused on those that were. He also said moves to link payments to outcome measures could compromise the positive effect. Measures dropped from the framework should still be reported so the effect of removing them could be monitored, he said.