Thirteen general practices in Leicester agreed to pilot a new health promotion payment, aimed at increasing advice on stopping smoking. Practices were paid £15 for identifying a patient who had stopped smoking for at least three months. Interviews were then conducted with at least one general practitioner and practice nurse from each participating practice.
The new pilot health promotion payment did not change behaviour towards advising patients on stopping smoking. Payment did not overcome general practitioners’ resistance to raising the issue of smoking when they felt that it could cause confrontation with patients. Many were strongly against wider introduction of payments but were more positive about payments that rewarded “extra” effort – for example, setting up smoking cessation clinics.
These findings show the value of assessing new financial incentives to general practitioners, say the authors. Future payments for health promotion should be carefully piloted and evaluated to determine whether they alter clinical practice, they conclude.