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GPs to carry out health checks in dementia carers under proposed QOF menu for 2014/15

NICE has launched a consultation on its proposed menu of 14 new QOF indicators for 2014/15, including new points for health checks in dementia carers, peripheral arterial disease and the use of ambulatory blood pressure monitoring in hypertension.

The proposed menu also includes ‘second-generation’ QOF indicators - called tightly linked measures (TLMs) - for diabetes, despite the institute’s own advisors saying there were serious issues with TLMs that needed to be addressed before they could be considered for introduction.

A consultation on the list of 14 indicators beings today and closes 4 February, and comes after the Government announced a raft of changes to the framework in the 2013/14 GP contract, including a hike in QOF thresholds, the removal of the organisational domain and the introduction of a new public health domain.

The list of indicators include advising women with diabetes about contraception and pregnancy, and new blood pressure targets in patients with peripheral arterial disease. Click here to read the full list of indicators

The NICE Primary Care QOF Indicator Advisory Committee will analyse the results of the consultation in June and then recommend the indicators that should be considered for inclusion. The DH and the GPC will then negotiate and decide which indicators should be adopted into the 2014/15 QOF.

Professor Gillian Leng, health and social care director at NICE, said: ‘The final menu of indicators, expected to be published on the NICE website in August 2013, will support healthcare professionals to improve the quality of patient care, based on the best available evidence.’

But Dr Peter Swinyard, chair of the Family Doctor Association, said the indicator for ambulatory blood pressure monitoring was welcome, but questioned the ‘box-ticking’ for diabetes patients.

He said: ‘Most diabetics will have to have statins coming out of their ears to get cholesterol <4 mmol/L.

‘There will be lots of box-ticking for diabetic women especially. Many of my diabetic female patients aged 45-55 years will find questions on risks of pregnancy fairly insulting.

‘There is so much box-ticking, [and] so little time for actually listening to our patients and addressing their agendas.’

The list of indicators includes:

  • The percentage of patients with a new diagnosis of hypertension after 1 April 2012 whose diagnosis was confirmed following ABPM
  • The percentage of patients with dementia with the contact details of a named carer on their record.
  • The percentage of carers (of a person with dementia) who have had an assessment of their health and support needs in the preceding 12 months.
  • The percentage of patients with a new diagnosis of dementia (after 1 October 2012) who have attended a memory assessment service up to 12 months before the date of diagnosis.
  • The percentage of women with diabetes under the age of 55 years who have been given information and advice about pregnancy, conception or contraception tailored to their pregnancy and contraceptive intentions recorded in the preceding 15 months.
  • The percentage of patients under 80 with a history of peripheral arterial disease whose last recorded blood pressure reading (measured in the preceding 15 months) was 140/90.
  • The percentage of patients with Type 2 diabetes aged 40 years and over with successful lipid management defined as either: last recorded cholesterol in the preceding 12 months ≤ 4.0mmol/l, last recorded cholesterol in the preceding 12 months > 4.0mmol/l and commenced on a moderate dose generic statin within 90 days of cholesterol recording, last recorded cholesterol in the preceding 12 months > 4.0mmol/l and generic statin dose increased within 90 days of cholesterol recording, or, last recorded cholesterol in the preceding 12 months > 4.0mmol/l and cholesterol lowering therapy changed to a different drug within 90 days ofcholesterol recording.

Click here to read the full list of indicators



Readers' comments (9)

  • Vinci Ho

    There is no surprise considering the extremely high profile 'promises' for dementia by PM and Healh Secretary.
    ABPM is technically and financially difficult but NICE guidance clearly said HBPM ( home BP monitoring ) with patient's machine over 7 days is well acceptable.
    QOFs have become harder and harder to achieve . GPs are no longer generalist.......

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  • And if the dementia suffer is registered with one practice nad the carer with another were does the responsibility fall?

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  • Is a residential home a Carer for the purposes of QOF?
    And I agree with anon about both carers registered with a different practice - with the additional problem that care may be shared (does this mean that both carers will need assesment?) and informal care arrangements change without GPs necessarily being informed.

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  • Are we penalized if the carer does not consent to be named? currently carers have to consent.
    There must be some more tricks up the sleeve of the Health Minister to reduce our income in further and make the already long and stressful working day even worse!!

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  • I would question whether you needed the carers consent to name them in someone else records? I use to partly help the old lady next door to me some years ago. I would have been furious to be listed in her records as one of her carers.

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  • Mark Struthers

    QOF is for donkeys.

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  • Mark Struthers

    A cholesterol level is meaningless ... except when the patient has statins coming out of their ears ... and then it probably means you're shortening the patient's life. When is the penny going to drop?

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  • i find the term 'carer' loathsome..i have helped and looked after several friends and relatives and would not allow anybody to name me as their 'carer' .it insults the relationship we have - equally i would not allow anybody to name themselves as my 'carer' when my turn to comes....consent should be gained before anybody identifiers others as 'carers'....a point which seems to have been missed.the person

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  • Just picking up on the bp monitoring... nice has clearly put in their guidelines that 7 day monitoring is ok. We only have one 24 hour one that works and even then there can be problems with pts taking them off. The surgery invested in new home monitors and pts do seem to prefer these as they have more control over them. Also if results from a 24hour one done over a stressful period this has its concerns. Personally I would be happy with seven day monitoring maybe allows more for variables

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