Background: The devolution of powers over public services from central to local government can enable policy makers to more closely meet the needs of local populations. However, devolved systems may lack the resources and expertise to efficiently implement change. There is limited evidence on...

The Quality and Outcomes Framework (QOF) is a Pay-for-Performance scheme introduced in England in 2004 to reward primary care providers. This incentive scheme provides financial incentives that reward the overall performance of a practice, not individual effort. Consequently, an important...