Tackling health inequalities in primary care: can performance indicators be a sustainable part of the solution?

Reducing health inequalities is a major NHS target.  Approaches include population targeting, such as Keep Well, and performance iondicators, such as the Quality and Outcomes Framework (QOF) and HEAT targets.  However, the extent to which these different approaches become normalised and embedded into routine practice varies.  This project will explore factors supporting and hindering their routine embedding and integration into practice and poliy.  The project will be conducted in two phases: (1) Re-analyses of up to 100 qualitative interviews with up to 30 national, regional and practice-based stakeholders about the use of HEAT targets.  The theoretical perspectives of normalisation process theory and Stewart’s mainstreaming framework will inform both phases.  Outcomes will include a better understanding of the factors supporting the normalisation and routine use of inequalities-focused performance indicators.


  • Kate O’Donnell (General Practice & Primary Care)
  • Frances Mair (General Practice and Primary Care)
  • Mhairi Mackenzie (Urban Studies)


Chief Scientist Office (£74,995)