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Gold, incentives and meh

Framework prevents CVD events

Two new studies predict sweeping benefits to public health from the quality and outcomes framework, with just five indicators alone capable of preventing thousands of CVD events each year.

Ten CVD events could be prevented each year in a typical practice, research suggests.

News of the research, presented at last week's Faculty of Public Health meeting in Edinburgh, comes with grassroots GPs set to launch a vehement attack on the new contract at this week's LMC conference.

Targets in the framework are achievable and can cut mortality, the studies suggest, with certain indicators having far larger effects on public health than others.

A University of Manchester study modelled the effect of the framework on cardiovascular disease, looking at the effect of meeting targets for prescribing aspirin, statins, anti- hypertensives, ACE-inhibitors or aniotensin-2 inhibitors, and flu immunisation for patients with coronary heart disease.

The study, based on a hypothetical population of 10,000, found dramatic differences in the effect of each indicator. It predicted that cholesterol-lowering therapy would cut the number of CVD events by 29.3 over five years, whereas meeting the target for aspirin treatment would prevent only 1.5 CVD events.

Professor Martin Roland, director of the National Primary Care Research and Development Centre and a co-author of the study, said hitting targets could prevent thousands of CVD events each year.

The second study reported the impact of Bromley PCT's quality care initiative, which set up registers for hypertension, heart failure, CHD, atrial fibrillation and diabetes and paid GPs for hitting targets, in a similar way to the framework.

Under the scheme, which predates the finalised framework, mortality from cardiovascular disease fell and practices either met or came close to their targets.

Michaela Nuttall, CHD co-ordinator for the PCT, said: 'Our mortality rates for cardiovascular disease have fallen. There was a national fall predicted, but our fall in Bromley was quicker.' She admitted the scheme had increased workload, but said it had given her a head start on the quality framework.

By Rob Finch

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