ABSTRACT
This chapter compares the process of quality measurement and quality assurance in primary care between the Netherlands and the UK. Primary care is, as Starfield has repeatedly argued, an essential component of any cost-effective healthcare system. A new National Health Service (NHS) contract for general practitioners (GPs) has recently been created in the United Kingdom (UK) in which core practice funding is supplemented by financial rewards related to the Quality and Outcomes Framework (QOF). The QOF itself, which provides practices with the opportunity to substantially increase their income by accumulating points awarded for reaching a range of targets, effectively embeds guidelines into the contractual arrangements for GPs. The continued evolution of quality frameworks for primary care requires continuing patient and professional input and also depends critically on some other key factors. The combination of clinical management guidelines, practice management and patients' views provides a widely applicable framework for judging the quality of primary care delivered by individuals and their teams.
