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NSF sets out GP kidney care role

The Government wants obesity targets and many more points for cancer and mental health in the next version of the quality and outcomes framework, Pulse has learned.

Primary care tsar Dr David Colin-Thome told Pulse he expected there to be extra quality indicators for cancer and mental health, and 'organisational markers' for the management of obesity.

GP experts in cancer and mental health called for the conditions to have 100 points each.

But GPs were much more cautious over the inclusion of obesity. The GPC was disparaging about the motives for including obesity targets and said it would resist the 'politicisation' of the quality framework.

Dr Colin-Thome said GPs could be paid for meeting organisational targets such as setting up a register of patients with a body mass index over 30 and referring obese patients to secondary care services.

He admitted there was too little evidence on the effectiveness of interventions for obesity outcomes to be included.

Dr Andrew Dearden, GPC Wales chair, said: 'The framework is there to help patients, not to help politicians win votes.' He insisted any new quality indicators would have to be evidence based and feasible in primary care.

Dr Peter Brindle, Wellcome fellow in health services research and a GP in Bristol, said patients would not want to be on obesity registers and their introduction could damage the doctor-patient relationship.

Dr Nick Brown, a GP in Chippenham and cancer lead of Kennet and North Wiltshire PCT, said cancer should gain the same number of points as diseases such as CHD, claiming there was 'a gulf in terms of priorities'. He said quality markers on cancer could cover screening, analysis of family history, two-week referral and palliative care.

A Drug and Therapeutics Bulletin review on opioid analgesics this week concluded GPs had 'an important role in managing pain'.

Dr Chris Manning, chief executive of Primary Care Mental Health and Education and a former GP, said nGMS was 'woefully flawed' on mental health. He said there should be 100 points available for targets such as depression diagnosis and identification of co-morbidities.

By Nerys Hairon

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