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Background There are many quality initiatives available to primary healthcare teams which should improve the quality of care given to patients. Engagement with these initiatives is often lower than expected. The Royal College of General Practitioners (RCGP) Quality Practice Award (QPA) has been achieved by only 8% of Scottish primary healthcare teams. The barriers that prevent teams completing this award were not known, though anecdotal evidence suggested that the intense workload over a short period of time was an issue. Aim The aim of this study was to identify the barriers to completing the QPA and to ascertain the acceptability of a modular approach to the process. Method An electronic questionnaire to each general practice in Scotland, providing quantitative and qualitative data. Results The main barrier identified was the time commitment required. This was followed by the cost to the practice. Particular problems with respect to smaller practices completing the QPA were identified. Other barriers included the need to involve all team members including attached but not employed nursing staff, a sense that clinical governance needs were already being met, and that the QPA gave no perceived added benefit. Fifty-five percent of practices indicated an interest in doing the QPA if a modular version were available. Conclusion RCGP (Scotland) will work with other colleagues in the field of quality improvement to develop a modular version of QPA and will investigate means of reducing its cost to a practice.