QOF drives up quality of diabetes care
Introduction of the QOF has
driven a sharp improvement in the quality of diabetes care, a comprehensive new analysis
The contract heralded rapid improvement in clinical measures such as blood pressure, cholesterol and HbA1c, and brought a burst of progress in practice organisation, writes Daniel Cressey.
The improvements are likely to be over and above progress that had been occurring anyway and indicate the contract is proving value for money, the
Study leader Dr Abd Tahrani, specialist registrar in diabetes and endocrinology at North Staffordshire Royal Infirmary, said: 'The majority of organisational indicators improved rapidly after implementing nGMS and then stabilised. Clinical indicators, such as HbA1c, BP and cholesterol, showed a sustained improvement.'
The study included data from all 66 practices in Shropshire, covering 16,858 people with diabetes. Dr Tahrani added: 'This improvement in Shropshire is likely to reflect a wider improvement in diabetes care across England.'
In April 2004, when the new contract came in, only 53 per cent of patients had a blood pressure of 145/85mmHg or less, but this had risen to 66 per cent by October 2005.
The proportion with an HbA1c below 7.5 per cent also rose from 53 to 66 per cent, and those with a cholesterol of 5mmol/l or less increased from 60 to 74 per cent (see graph left).
There were significant improvements in recording of neuropathy testing, drug treatment, microalbuminuria and serum creatinine.
GPC negotiator Dr Richard Vautrey, said: 'This confirms what we've been saying all along. You're looking at hard
results here – results that can't be gamed. The QOF has made a major impact on care.'
Dr Martin Hadley-Brown, chair of the Primary Care Diabetes Society and a GP in Thetford, Norfolk, said: 'People have focussed and worked very hard. It demonstrates that QOF has been a great success.'