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Independents' Day

In summary: What does NICE want to remove from the QOF?

Read a summary of the NHS England review of the QOF by advisors at NICE and download the full document.

NICE advisors recommended all indicators on atrial fibrillation, CHD, PAD, hypothyroidism, asthma, COPD, dementia, mental health, cancer, palliative care, epilepsy, osteoporosis and rheumatoid arthritis are retained.

They recommended the following should be removed from the QOF:

  • 12-monthly annual reviews (revert to 15-monthly)
  • HYP004 and HYP005 (worth 11 points in total)
  • DEP001 (21 points)
  • OB001 for obesity case-finding (8 points)
  • Learning disability indicators LD001 and LD002 (7 points in total)
  • Maternity (MAT001) and child health surveillance (CHS001) (12 points in total) – more appropriately delivered through CCG outcomes indicator set
  • DM0015 and DM0016 – could be temporarily removed or included in DM0014
  • ‘Some’ CVD prevention and smoking indicators

They also recommended the following should be looked at:

  • Cutting follow-up review invitations – as most patients may attend after the first invite
  • CKD indicators – to be reviewed after NICE guidance update
  • Cervical screening and contraception indicators – to be reviewed with Public Health England input
  • Moving further indicators into other frameworks, eg, CCG outcomes indicator set
  • Introducing broader clinical areas – to simplify
  • Recycling clinical areas – periodically removing and reintroducing them

Source: NICE QOF committee – meeting minutes

Readers' comments (8)

  • The smoking rules must be amended - If I see a new patient today & record that they are an ex smoker & stopped 30yr ago (I presume all clinical systems can record date stopped), why on earth should I have to ask them for each of the next 2 years to see if they have reastarted? More often than not, they don't attend one year & the clock starts again - a total waste of time & it makes us look stupid in the eyes of the patient.
    There is some clinical sense to asking about erectile dysfunction, but are we to do this annually? What about the older man who admits to it & says he is not interested in remedying the situation? Is it clinically justifiable to humiliate him annually by asking again? A lifetime exception should apply once a patient declines.

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  • Are we supposed to be grateful for removal of indicators and workload that should never have been imposed in the first place?

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  • Why not have an online form that the patient can complete within the surgery that can be directly linked to his med recs' and save the doctor time asking silly questions repeatedly.

    It systems should be able to 'red flag' areas of concern automatically. given the time a GP sees a patient, who has asked to see him for another problem, do they really have time to ask a whole list of questions and ignore the reason he / she is there that day?

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  • one thing NICE forgot

    why pay for keeping a register of the LTC when it should be mandatory requirement

    you cannot run a LTC clinic without a register

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  • what will happen to the finances associated with these indicators?
    the same finance which already been recycled from other work we do.

    it'll go towards paying for even more work and targets just not under the 'QoF' title

    I'd rather it remains under a structured national framework than some of the impossibilities they could send our way...or even some of the ridiculous things and reporting forced on us by our own peers at CCG towers

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  • ...and you honestly think that removing some (NB:not all) indicators is going to persuade me to open my surgery 8am-8pm 7 days a week!

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  • In reply to Dr Trowell

    The smoking rules have been amended this year, Ex smoker now changed to 3 successive entries EVER or recorded in current year

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  • As with the recycling of QOF monies and transfer of services from secondary care to primary care - we just get more responsibility without extra income - Its tome to make decision - Gps have 3 options - leave general practice [start a family -already very popular] retire, emigrate. - as we know hospitals would run a lot smoothly without patients - perhaps primary care will exist without any clinicians. Looks as though HMG are giving it a go

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