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Cato Pedder reports on this week's British Cardiac Society meeting, where details emerged of tougher treatment targets

GPs may have to clear higher hurdles in the next draft of the quality framework after cardiovascular experts submitted evidence on the need for tough new quality indicators.

GPs would have to control 80 per cent of their CHD patients to the cholesterol target of 5mmol/l to gain maximum points under the proposals from the Primary Care Cardiovascular Society (PCCS).

The society also wants to see primary prevention of coronary heart disease and an indicator for atrial fibrillation in the updated framework from 2006.

The GPC said robust new evidence was critical before any quality indicators were changed or added. It expressed particular scepticism over the proposals for primary prevention, saying the data would have to be looked at 'very, very carefully'.

The PCCS evidence has been submitted to the quality framework review group ahead of the May 30 deadline.

The society also wants the cholesterol target to be reduced to 4mmol/l, in line with new Joint British Society guidelines expected in September, but acknowledges such a change would need to be phased in.

Dr Stewart Findlay, PCCS member responsible for submitting evidence on cholesterol targets, said: 'In 2006 we want to see a cranking up of the percentage to hit to get maximum points. My view is we could probably push it as high as 80 per cent, but I

suspect the review will go for a lower target, such as 70 per cent.'

Dr Richard Vautrey, GPC negotiator, said changing the maximum threshold would 'raise questions about the benchmark' set in the QOF.

Dr Findlay added that the PCCS was pushing for a new primary prevention indicator, involving identifying and treating all people with a 30 per cent 10-year risk of developing CHD. He said: 'It is clear these people should be on some sort of treatment.'

But Dr Vautrey warned: 'Primary prevention is a huge area. We would have to look at the evidence very, very carefully on whether primary intervention in primary care can make a significant difference.'

Tough new targets on CHD: proposal from

Primary Care Cardiovascular Society

·Raise maximum threshold of patients with CHD with total cholesterol below 5mmol/l to 80 per cent

·Add indicator for primary prevention of CHD, including identifying and treating patients at risk

·Add indicator on atrial fibrillation, including a register of patients and ensuring they are on appropriate treatment such as aspirin or warfarin

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