Portugal, Italy and Sweden should also foster leadership of PCPs in prevention programmes (OECD, 2013b, 2014c, 2015d). These countries lack measures to support PCPs to take on responsibilities for managing chronic conditions. England’s QOF is one of the largest programmes worldwide to embed evidence-based measures for secondary prevention in chronic disease management in primary care. The programme gives GPs a financial incentive to provide evidence-based care for a wide range of LTCs, including diabetes.