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Health checks set for next QOF

By Lilian Anekwe

GPs are likely to be expected to conduct regular health checks in patients with learning disabilities under the next revision of the quality and outcomes framework.

The Department of Health has revealed it sees incentives for health checks as among its top priorities for the next round of contract negotiations.

In its report Promoting Equality, published last week, the department set out its strategy for tackling the health inequalities experienced by people with learning and mental health problems.

It follows a series of problems highlighted earlier this month by the Disability Rights Commission.The report includes the recommendation to 'include incentives in the GP contract for evidence-based regular health checks for people with learning and/or enduring mental health problems'.

It goes on to add: 'Health checks are the most effective way to improve the health of people with learning disabilities or mental health problems. In future contractual negotiations with GPs, one of our priorities will be access to regular health checks for people with learning disability.'

GPs in Wales are already incentivised to provide regular health checks for people with learning disabilities through an enhanced service.But Dr Andrew Dearden, chair of GPC Wales and a GP in Cardiff, said incorporating health checks into the GMS contract seemed a 'stupid' way of providing the funding.

'I'm always staggered by the Government's love of doing things the complicated way. Why go through a regulatory change when it could be done as an enhanced service? Learning disabilities don't change as you go across the border. So when you have a nice round wheel that works, why invent a square one?'

Dr Alison Allborz, a lecturer in learning disability studies at the University of Manchester, welcomed the move but warned there would be many details to fine-tune.'Pretty much everyone agrees checks should be done, and the obvious place would be general practice, either by a practice nurse alone or with GP input.

'But the report doesn't say what kind of model they are considering as the best to implement, and it doesn't state how regular is regular. Ideally it would be annually, but every two years may be more practical with GP resources.'

How health checks work in Wales

A GP with a list of 2,000 patients receives £100 for each of about eight patients with severe learning disabilities. The annual health check includes:• Recommended, top-up and flu immunisations• Cervical and breast screening• A physical examination for chronic illness, communication and mobility problems, and epilepsy• Investigation of any behavioural disturbance• A medication review

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