Tim Burr, head of the National Audit Office, said in 2008: "There is no doubt that a new contract was needed and there are now 4,000 more GPs than five years ago. But in return for higher pay, we have yet to see real increases in productivity."
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Further changes to the QOF for 2008 included the addition of new indicators for COPD and smoking cessation.
Since 2004, the UK Quality and Outcomes Framework, a performance-related pay scheme for primary care practitioners, has effectively mandated the use of computer systems (such as Vision) to maintain patient medical records, and has imposed standardised recording methods for a wide range of important medical conditions.
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