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Table 3 Coding schedule

From: `Just another incentive scheme’: a qualitative interview study of a local pay-for-performance scheme for primary care

Deductive coding to areas taken from literature Inductive codes emerging from interviews Iterative refining of deductive and inductive codes and themes Final themes
Influences on behaviour: Motivation: Practitioner motivation: Influences on behaviour
Ownership of change Support among practices Patient benefit Financial reward  
Motivation (intrinsic and extrinsic) Financial reward   Patient benefit  
Competition with other practices  
Social comparison     
Organisational means     
Relevance: Opinions: Attitudes towards the scheme:  
Clinical benefit Clinical value Don’t agree with localisation Role of general practice  
Local population needs Credibility Lack of knowledge/interest in evidence Acceptance/rejection of an externally defined way of working  
  Prevalence   Faith in the evidence  
Distribution of workload Uneven workload    
Scope for gaming Minimal change    
Implications for tackling inequalities The bigger picture    
  Failed to address inequalities    
  Adjusting role of general practice    
Appropriateness of incentivised targets: Credibility:   Credibility of the locally negotiated indicators
Robustness of evidence base Conflict with professional identity Other guidelines   
Costs Conflict among practice staff Clinical value   
  Conflict with patient benefit Conflict with/supported by prevalence in population   
  Funding improves credibility    
Acceptability: Effect on professionals: Effects of implementing a local scheme: Exacerbating tensions
Compare to national QOF Just another income stream Created an uneven workload Allowed local issues to be addressed  
  Conflicting credibility with NQOF   Caused inequalities  
Consequences: Effect on patients: Consultation consequences  
Effect on practice staff Adapt consultations Standardised care Target became routine practice  
   Effect on consultations:   
   Adapt templates as aids   
Effect on patients and patient care Impact on patient experience Embedded behaviour   
  Time pressure Required minimal change   
  Conflicting agendas    
  Distracting in consultations    
  Embedded behaviour    
  Standardised care    
Recommendations: Recommendations: Experience of engagement Ownership
How it should be introduced Evolving assessment process LoQOF champion Highlight available external support for data extraction and management  
Local versus national benefits and harms Extension of NQOF Patient involvement Familiarisation period before data collection  
  Conflict with NQOF Bottom up approach   
  Bottom up approach Based at cluster level   
  Setup time Outside support   
   Protected learning time for all staff   
   Data support