These researchers examined the relation between socioeconomic inequalities and delivered quality of clinical care under the quality and outcomes framework, a financial incentive scheme that remunerates general practices in the UK for their performance against a set of quality indicators. Overall levels of achievement, defined as the proportion of patients who were deemed eligible by the general practices for whom the targets were achieved, were calculated for 48 clinical activity indicators during the first 3 years of the incentive scheme (from 2004–05 to 2006–07). Median overall reported achievement was 85.1% in year 1, 89.3% in year 2, and 90.8% in year 3. In year 1, median achievement was higher in least deprived areas (quintile 1; 86.8%) than in most deprived areas (quintile 5; to 82.8%). However, between years 1 and 3, median achievement increased by a greater amount in quintile 5 than in quintile 1 (4.4% vs 7.6%), and the gap in median achievement narrowed from 4.0% to 0.8%. A significant inverse association was observed between the increase in achievement during this time and practice performance in previous years (p<0·0001); no such association was seen with area deprivation (p=0.062).
