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Controversial QOF depression indicators spared axe

Controversial indicators on depression are to remain in the QOF, despite recommendations from NICE that they are ineffective, lead to over-diagnosis and should be scrapped.

But the deal agreed between the BMA and NHS Employers includes a pledge to pilot a new  assessment tool  to replace the questionnaires currently validated for primary care.

NICE's QOF indicator advisory committee voted to scrap points for screening for and assessing severity of depression in June following a deluge of complaints from GPs.

But mental health charities and some experts lobbied hard against any changes, with Dr Alan Cohen, former national primary care lead for the Improving Access to Psychological Therapies Programme, writing in Pulse that removing the indicators would be a ‘grave mistake',

A NICE spokesperson said the ultimate decision rested with NHS Employers, the Department of Health and the BMA. ‘The QOF negotiations ultimately decide which of the proposed recommendations will be used within the QOF framework.'

Professor Tony Kendrick, a GP in Hull and a member of  the QOF indicator advisory committee, told Pulse: ‘The committee was clear it didn't want to neglect depression and wanted to develop new assessments that didn't rely on questionnaires, and I would hope that will be developed soon.

 ‘My personal view is that keeping these indicators in for the moment is good for people with depression because they are still being assessed and followed up. Having the current indicators is better than not having them at all.'

But Dr Gavin Jamie, a GP in Crawley, Sussex, who runs the QOF Database website, said the decision was incomprehensible.  ‘A lot of things NICE said should go haven't gone, like depression, which NICE acknowledges are useless. I can only guess it's been left here for political reasons.'

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