The payment for performance model and its influence on British general practitioners' principles and practice

Area of Science:

• Healthcare Policy
• Primary Care Medicine
• Medical Ethics

Background:

• The British payment for performance (P4P) model influences healthcare delivery.
• Understanding its impact on general practitioners' (GPs) professional ethos is crucial.
• Primary healthcare quality in low and middle-income countries may be affected by financial incentive modalities.

Purpose of the Study:

• To explore UK general practitioners' perspectives on the effects of the British P4P model.
• To investigate how P4P influences professional ethos and practice.
• To assess potential implications for primary healthcare services.

Main Methods:

• Semi-structured interviews were conducted.
• 13 general practitioner educators and leaders in academic medicine across the UK participated.
• Qualitative data analysis explored themes related to P4P impact.

Main Results:

• A shift towards a biomedical practice model and fragmented care was observed.
• Increased focus on specific disease conditions by healthcare staff.
• Greater medicalisation of patient experience, including increased medication prescription over non-pharmacological interventions.

Conclusions:

• The British P4P model has reinforced a scientific-bureaucratic approach to medical practice.
• Significant effects on the practice of family medicine in the UK.
• Potential implications for primary healthcare quality and professional values.