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GPC agrees to increase QOF points for dementia care planning

There will be an increase to the number of points for dementia care planning in next year’s QOF after GPC and NHS Employers agreed to retire indicators relating to CKD and coronary heart disease.

The changes, which GPC and NHS Employers describe as ‘minor’, will see the size of QOF remain unchanged, and will also involve changes to AF indicators.

The announcement follows the recent contract agreement. The changes to QOF include:

• The amendment of atrial fibrillation indicators as recommended by NICE with additional points to reflect the workload involved.

• An increase to the number of points for dementia care planning and annual reviews.  This is in response to a growing number of patients with dementia.

• Funding of the above, is through the redistribution of 36 points and the retirement of a number of indicators (Chronic Kidney Disease and Coronary Heart Disease). Practices will continue to treat these patients as clinically appropriate.

• QOF overall will remain at 559 points.

Dr Richard Vautrey, deputy chair of the GPC and its lead on QoF, said: ‘It is important that general practice plays its part in meeting the needs of the growing number of individuals suffering from dementia as well as supporting their carers, particularly as dementia is expected to affect a million patients by 2021.

‘These important clinically appropriate changes to QoF recognise the rising practice workload involved in ensuring that patients with dementia get the best possible care. In addition, changes to the treatment of atrial fibrillation will help to reduce the risk of strokes and ultimately save lives. The reforms to the chronic kidney disease domain will reduce the focus on box-ticking and free up GPs to treat these patients according to their clinical need.’

Readers' comments (5)

  • Lets hope that care planning has consideration of other standards and is not just a tick box claim. Patients are a vital part of this process, yet often patients are not even aware they had a care plan, let alone its detailed content.

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  • Care planning is of zero clinical value, it's just a buzz word. It certainly does not improve care of people with dementia. There is no outcome data for it. Making it easier for patients to access services is for more important, eg patient or their carers being allowed to self refer to dieticians, or too receive funding from councils to live as independant lives as possible.

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  • care planning is a bit like the old nursing logs, good night good morning ate porridge opened bowels died.
    accurate but useless

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  • Michael Bond

    Good general practice does this already: planning care is about recording intended or anticipatory action.
    A regular check on progress of disease, like an AMT; a medication review; noting the usual carer and how they're coping; noting end of life care preferences, ... all these things are part of a plan.
    The trick is to make sure that this is shared with everyone involved, especially the person who is the focus of care (preferably without them having NICE or QOF "branded on their soul" - Paul Hodgkin)
    Don't get bogged down with labels or previous examples of bad record keeping. We all need to move on.

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  • I don't disagree with you Michael. Problem is, if you make common sense into large volume tick box exercise the sense will be lost. Patients become careplans rather then a human being and the ethos of the care is lost as we would have to concentrate on the quantity, rather then the quality (i.e. personalized details with in depth discussion). It often does not add to patient's care, but rather hinders it by taking clinicians away from clinical setting.

    You must remember this is extra work with no new funding."Retiring" old indicators does not stop us treating patients with CKD and CHD.

    I can still see daily entries from our local Hospice which shares the same record system and there are masses of
    "daily goal achieved"
    "ate breakfast"
    "bowels opened"
    "No pressure sore"
    "Patient washed"
    as part of their care plan and record keeping. It's polluting the record so much I can't actually find useful clinical information when I need it. And I very much doubt they can either after a week of doing this.

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