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Previous Volume 351:1448-1454 September 30, 2004 Number 14 Next

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Family practitioners are the main primary care physicians in the United Kingdom, making up half of the medical workforce in the National Health Service (NHS). In April of this year, family practitioners entered into a contract with the government that will provide additional payments for high-quality care in excess of £1 billion ($1.8 billion) — more than 20 percent of the previous family practice budget. One American commentator described this as "an initiative to improve the quality of primary care that is the boldest such proposal attempted anywhere in the world" and suggested that "with one mighty leap, the NHS . . . [Full Text of this Article]

The Professional Context

The Academic Context

The Political Context

The Negotiating Process

The Quality and Outcomes Framework

Clinical Indicators

Organizational Indicators

The Experience of Patients

Financial Rewards

Implementation and Inspection

Consequences of the Contract

Source Information

From the National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom.

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