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Osteoporosis in line to be added to next QOF

By Emma Wilkinson

Osteoporosis and use of ?-blockers in heart failure have emerged as front-runners for inclusion in the next version of the QOF, Pulse can reveal.

The Department of Health and review group experts have contacted two separate research groups for data to support the development of a

?-blocker indicator.

And the department's elderly care tsar confirmed osteoporosis was also top priority for inclusion during an exclusive interview with Pulse.

NHS Employers has already requested data from a major audit of osteoporosis management.

The GPC and NHS Employers are expected imminently to announce details of the QOF review for 2007/8, with indications that the expert panel will target areas for consideration to reduce unsolicited submissions.

Professor Ian Philps, the department's national director for older people's services, said: 'For me, osteoporosis is the top priority for the QOF review because the evidence is clear there is a group of vulnerable people who can be identified.

'It's very important GPs engage in identifying people at risk of falls and fractures and referring them to the falls and bone health services. I would like to see GPs rewarded for that.'

He said extra indicators for dementia were also a priority.

The NHS Confederation QOF review team has approached the Gloucestershire Primary and Community Care Audit Group for details of the criteria used in the county audit of falls and bone health. The team also requested details from the group of heart failure audits.

A separate heart failure clinic in Darlington has been approached for data to inform the development of appropriate percentage thresholds for a

?-blocker target.

Dr Ahmet Fuat, a GP in Darlington who runs the one-stop diagnostic clinic for suspected heart failure, said: '?-blockers cut mortality, morbidity and hospital admissions, and improve quality of life. QOF should support this sort of evidence base rather than woolly measures of weight or depression scores.'

Dr John Canning, secretary of Cleveland LMC, said inclusion of the indicators seemed 'reasonable' but warned: 'What we can't have is the QOF taking on more and more things without proper funding.'

· Percentage of patients with heart failure treated with a ?-blocker, who can tolerate therapy and have no contraindications

· Percentage of patients aged over 75 living in a residential home or nursing home prescribed calcium/vitamin D3

· Percentage of patients aged over 65 with three-month exposure to oral steroids treated with an appropriate bone-sparing agent

· Percentage of women aged over 75 with fragility fracture, or between 65 and 74 with fragility fracture and osteoporosis confirmed on DEXA scan, treated with appropriate bone-sparing agent

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