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Independents' Day

NICE set to streamline cardiovascular QOF indicators

By Lilian Anekwe

NICE are looking at ways of reshaping the QOF to create a ‘composite register' for cardiovascular disease, to streamline the framework and minimise the overlap between different disease areas.

At a meeting this week, the independent QOF indicator advisory panel, which was appointed by NICE to oversee the revamp of the framework, revealed they were exploring the possibility of creating a composite register for patients with all cardiovascular diseases in the menu for the 2012/13 QOF.

The plans have been mooted previousl, as early as August 2007 when Pulse revealed ministers were drawing up proposals to radically streamline the cardiovascular indicators in the QOF to squeeze in new targets and combat concerns over double counting.

Under the plans, a number of separate cardiovascular indicators would have been merged into one to avoid paying GPs more than once for patients on multiple CVD registers.

The proposals were first suggested to the Department of Health in an advisory report exclusively revealed by Pulse in February 2007 and at the meeting in Manchester it became clear NICE will seek to revisit the issue as part of its future ‘strategic direction'.

Pilots will be run by Professor Helen Lester at the National Primary Care Research and Development Centre, who said it would be ‘very difficult technically' to create an overarching cardiovascular disease register.

But the Committee are keen for NICE and the NPCRDC to develop the IT and explore how to create a single cardiovascular domain.

Dr Tim Stokes, consultant clinical advisor for the NICE QOF programme and a GP in Leicester, said: ‘We need to think in terms of a strategic move toward secondary prevention within all groups of cardiovascular disease.'

The committee discussed the feasibility of developing a composite register, and that while it would be challenging, the idea should be explored further.

One committee member said: ‘I can see the technical problems of having a cardiovascular QOF section but I think that's where the evidence is moving towards and where we and the QOF should be moving towards.'

Another committee member added: ‘I don't see why there can't be a single CVD domain in the QOF. There's no reason why issues such as blood pressure can't be bundled together.'

The committe also acknowledged care would need to be taken to make sure it would ‘strike a balance between a disease-centred approach and a patient-centred approach'.

NICE plans a ‘composite register' for cardiovascular disease in QOF, including hypertension

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