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Alert over QOF diabetes tests

GPs are being warned that their lab's choice of diagnostic test to confirm if a patient has diabetes could affect QOF payments – particularly if HbA1c targets are toughened.

Researchers compared two different laboratory techniques – the Variant II analyser and the Tosoh G7 – used to analysed blood glucose levels in blood samples taken from patients with poor glycaemic control.

Of 161 randomly selected samples, 60% and 68% of patient specimens had an HbA1c of 7.4% or lower with the Variant II analyser and the Tosoh G7, respectively. Median HbA1c levels were 7.2% and 6.9% respectively.

The researchers concluded that a difference of 7.5% in the absolute number of patients classified with poor glycaemic control was not enough to cause any substantial financial difference under current GMS criteria – which awards points for the percentage of registered patients with a HbA1c of 7.5% or lower.

But they warned that if the criteria for exception reporting or the HbA1c target for QOF target DM20 were toughened, the difference could have a significant effect on practice income.

Dr Patrick Twomey, a consultant in pathology at the Ipswich Hospital and lead author of the research published in the International Journal of Clinical Practice, said: ‘Despite a statistically significant difference between the two methods, there would currently be no difference in the number of points earned.

‘However, should the target be decreased, the statistical difference between the methods employed in this study is more likely to result in a difference in the payment to a GP.'

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