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Outcome-based quality indicators 'won't work', says QOF panel chief

By Nigel Praities

A shift towards more outcomes-based measures in QOF is not likely to be practical for primary care, says the boss of the new QOF indicator selection panel.

Dr Colin Hunter, chair of the QOF Indicator Advisory Committee at NICE, said aspirations to include more outcomes measures – as expressed in the Government's response to the consultation on the QOF – would be unhelpful and probably would not work.

His comments come weeks after Pulse revealed Government ministers were keen to include more public health measures based on outcomes in the QOF, such as smoking quit rates and reductions in alcohol consumption.

‘In theory, it sounds more appropriate to focus on outcomes, but in my experience – and I need to be persuaded otherwise – actually you have to proxy with good process markers largely.

‘Outcomes in QOF would not deliver what we need to deliver. It is part of the job of the committee to ensure they are meaningful and verifying the indicators work in a clinical setting,' he said.

The QOF committee will meet next month to discuss what criteria they will use to choose new indicators. Dr Hunter played down concerns QOF would end up slavishly adhering to NICE guidelines.

‘Not all guidelines are applicable or fit the purpose of the QOF. You may have the expectation that this will be the Pandora of implementation for all NICE guideline, but it will only work where it fits the model and guidance meets the criteria that we are setting on clinical effectiveness, cost effectiveness and impact,' he said.

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