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Risk factors identify who urgently needs DEXA scans

It is time for the Government to review the quality and outcomes framework and set chronic disease targets for patients rather than doctors. For hitting the targets, patients would get vouchers to pay for prescriptions, gym membership or their children's education.

A heavy smoker could aim to become a non-smoker. Diabetics would be rewarded for achieving low HbA1c, low BP and reducing weight. Similarly, heavy drinkers would get points if they cut their drinking consumption.

It would be much more sensible for patients to be in charge of their health and incentives would encourage them to change their lifestyle. The points could be monitored by doctors or health workers.

Dr Sivaram Devaraj

Twickenham

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