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GPs set to be incentivised for referrals to talking therapies as NICE endorses QOF indicator

Practices could be incentivised to refer more patients with depression and anxiety for talking therapies under a new QOF indicator rubber-stamped by NICE advisors, despite opposition from the GPC and RCGP.

The indicator - which will reward practices for referring patients within three months of diagnosis - was agreed at yesterday’s QOF indicators advisory board meeting in Manchester, after piloting showed the approach led to a big increase in referrals to psychological therapy services, from around 4% to 20% of patients.

The RCGP and the GPC had opposed the indicator on the grounds that many patients with relatively mild depression and anxiety do not need referral and that IAPT services are already over-stretched, while the coding and timing of diagnosis of both anxiety and depression can be uncertain.

However, NICE advisors said evidence showed GPs were not referring people to psychological services frequently enough - and that the codes for diagnosis would be expanded to capture symptom-based codes as well as firm depression or anxiety diagnoses codes.

The chair of the QOF/CCG outcomes indicator advisory panel, Professor Danny Keenan, told Pulse the indicator would help drive an expansion of IAPT services.

Professor Keenan said: ‘It will drive development of the psychological therapies. We obviously need more facility but this is what will drive an increase in facilities.’

In the same meeting, the panel decided to recommend the inclusion of a new QOF indicator rewarding practices for how many patients they treat with statins at the 10% primary prevention threshold, despite unease among GP members on the independent advisory panel.

Readers' comments (11)

  • Such a mundane task for an already practised affair. South London waiting time - 12-15 weeks.
    Clog up the ailing system.
    'Nice' plan.

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  • The GP Patient Survey included a questionnaire on anxiety and depression. Approximately 30% of the Population of England indicated to have to mild/moderate/severe or extreme depression/anxiety.

    The present waiting time referring 2-5% top most symptomatic patients is 8 weeks!

    I suggest the 2/3 rd of the population who don`t have either would be fully engaged talking to the depressed/anxious one third!

    NICE one NICE!

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  • % N
    1. I am not anxious or depressed 68% 576011
    2. I am slightly anxious or depressed 19% 163398
    3. I am moderately anxious or depressed 9% 74026
    4. I am severely anxious or depressed 2% 19587
    5. I am extremely anxious or depressed 1% 9812
    Total 842834

    http://results.gp-patient.co.uk/report/1/rt1_result.aspx?sid=9&qid=144

    I hope NICE looked at this before saying GP`s are not referring more patients for IAPT!
    31% of the population needs referring based the GP Patient Survey!

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  • Our local waiting list for counselling is 6 months. Really useful. Cant wait for it to become 12months under this stupid plan. Arses and elbows

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  • I would happily refer all patients with anxiety +/- depression, but the local service is currently overwhelmed despite the fact we only refer a fraction patients with these conditions. The waiting time is sometimes 4,5 or even 6 months, and this is for patients with the most severe symptoms! The service would collapse if we even doubled our current referrals. More pie-in-the-sky nonsense.

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  • Did they used received typed referrals as the metrics? Many of us give patients the self referral info.

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  • This comment has been removed by the moderator.

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  • Now let's guess who will be getting the more desirable talking therapies and which groups the notoriously harmful drugs.....

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  • A lot of anxiety we see is acopia with crap life syndrome.
    They need a bestie to talk to, zumba/yoga class for personal space, no 2nd job as well as being primary carer/ Mum Dad whatever and the occasional decent bottle of their fancy.. A smaller mortgage and decent support for their illnesses woes etc.... A cuddle and and an 'I love you' from their wife , husband kids family or friends.
    IAPT for real cases. For others reassurence that they're not mentally ill, a decent self help guide and a GP open to them coming back if things do not go so well.

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  • It's self referral, otherwise the Dna rates become very high ,

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