physicians benefit by having the capacity to compare their performance against that of their peers this is a move consistent with scotland s bottomup approach to quality improvement and reluctance to use financial incentives to promote health care quality special nhs boards that do not provide direct patient care return their savings in order that they are recycled into the overall funding available to support patient care much of these savings are expected to be found by through improvements in the quality of care by reducing unnecessary hospital stays unplanned readmissions and adverse events for example