Financial incentives are seen as one approach to encourage more systematic use of smoking cessation interventions by healthcare professionals. In a study published in the journal Tobacco Control, Dr Fiona Hamilton and colleagues from the Department of Primary Care & Public Health at Imperial College London carried out a systematic review to examine the evidence to support financial incentives for health professionals as a method for improving smoking cessation activities.They found 8 studies examined smoking cessation activities alone and 10 that studies that examined the UK's Quality and Outcomes Framework, which contains quality measures for chronic disease management including smoking recording and smoking cessation activities. Five non-Quality and Outcomes Framework studies examined the effects of financial incentives on individual doctors and three examined effects on groups of healthcare professionals based in clinics and general practices. Most studies showed improvements in recording smoking status and smoking cessation advice. Five studies examined the impact of financial incentives on quit rates and longer-term abstinence and these showed mixed results.They concluded that financial incentives improve recording of smoking status, and increase the provision of cessation advice and referrals to stop smoking services. however, the evidence that financial incentives lead to reductions in smoking rates is more limited.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...

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