A government-funded study has found GPs are gaming their quality and outcomes scores to increase their income.

Doctor Behaviour Under a Pay for Performance Contract: evidence from the quality and outcomes framework concludes that the framework provides perverse incentives for gaming.

The report found that some practices which had reached the upper threshold the limit above which they receive no extra income for treating more patients had gamed the number of patients with a certain condition to increase the price per point they were owed through prevalence.

It found that some practices below the upper threshold had increased reporting of patients unsuitable for treatment and those who refused it, to increase the proportion of patients they had treated.

It says: 'The incentives in QOF also affect case finding and reporting by practices, and we found evidence that practices which performed worse in 2004-05 had lower reported prevalence in 2005-06.'