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GPs to record BMI of patients under QOF indicator approved by NICE committee

NICE's QOF committee has given the green light to new indicator that will see GPs incentivised for recording the BMI of all adult patients. 

The indicator, discussed at the NICE indicator advisory committee meeting yesterday, will see QOF points awarded to practices that record BMIs in patients that are aged over 18, every five years.

The indicator will be put forward for negotiation within the profession before it is officially implemented as a QOF target - but the GPC told Pulse it would oppose this.

The panel of the committee – made up of GP members and NICE specialists – decided that the indicator was a pragmatic approach to measuring BMI, potentially giving patients the wake-up call needed to change their weight, without impacting significantly on consultation time. 

But another proposed indicator for GPs to give weight management advice to patients with a BMI of 25 or over was rejected after members of the panel voiced concerns that the move would become a tick-box exercise. 

It was initially proposed that GPs should give advice to overweight patients within 90 days of recording their BMI, but this was met with objection after the evidence base for the move came under scrutiny from the panel, with it being decided that such an approach is not practical in primary care.

The chair of GPC's clinical and prescribing subcommittee, Dr Andrew Green said: 'I welcome the decision not to proceed with the proposed indicator regarding weight loss advice for the minimally tubby, but we opposed, and will continue to oppose, routine BMI recording.'

Dr Green argued that 'GPs should only be tasked with activities that only GPs can do', adding: 'The last time I looked measuring height and weight did not require a medical degree, and the evidence for unsolicited intervention making a significant difference to patients' weight is minimal.

'The time that GPs have with patients in precious, every unnecessary activity inevitably degrades the quality of the rest of the consultation, and GPC will resist any attempts to increase the burden that data-collection during consultations imposes.'

A spokesperson for NICE said: 'We want to make clear that the indicator does not stipulate that the BMI measurement should be undertaken by a GP.'

NICE also pointed out that its QOF committee is independent and advisory. 

'The discussions and decisions made today may change and are subject to final validation by NICE’s guidance executive who make the final decision about what is included in NICE’s indicator menu,' the spokesperson said.

It comes as NHS England launched a national programme in March this year to get 20,000 people at risk of diabetes to lose weight and take more exercise, as part of the Government's flagship diabetes prevention programme.

But Pulse reported that four out of five patients targeted in the programme's pathfinder pilots had refused to attend their prescribed lifestyle programme.

More recently, Pulse has also reported that a cut to public health budgets has led to weight loss and exercise programmes being axed by councils.

Approved indicator

  • % of patients 18 or over with a BMI recorded in the preceding 5 years

Rejected indicator

  • % of patients 18 or over with a BMI greater or equal to 25 in the past year given appropriate weight management advice within 90 days of their BMI being recorded

 

 

Readers' comments (17)

  • Shows what a weird universe NICE inhabits. They think that a good use of scarce GP time and scarce taxpayers' money is measuring height and weight.
    It's high time the GPC shouted and ranted instead of playing nicey nicey.

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  • And there was me thinking that the year on year changes to QoF was to be killed off. THERE IS A RECRUITMENT CRISIS

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  • QOF is basically dead.

    Disband this group.

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  • Is this going to be a target as of this years QOF or next? Also a lot of people complaining about this being implemented but think if it is an eye opener for patients how much money it could save in the long term when it comes to these patients not requiring gastric surgery or treatment of diabetics

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  • "Anonymous | Other healthcare professional14 Jun 2016 4:49pm

    Is this going to be a target as of this years QOF or next? Also a lot of people complaining about this being implemented but think if it is an eye opener for patients how much money it could save in the long term when it comes to these patients not requiring gastric surgery or treatment of diabetics"

    That is an extremely naive view and contradicted by all the evidence. Every new politico or NHS manager comes up with "patient education" as the answer, it never works. Patients can see how fat they are, do you really believe being told you have some number value XYZ that is meaningless to them, will suddenly make them diet and exercise?

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  • I have given up referring overweight patients to dieticians because their advice does not work. If it did why would there be so many overweight dieticians ?

    The advice they want us to give is wrong, and makes the situation worse. It is not fat that makes people fat but carbs. Many people cannot tolerate sugar and starches. If they want to have a normal weight they have to give up eating bread,potatoes,rice and pasta. It is not very popular advice but it works.

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  • Absolutely nonsensical and imbecilic and grotesquely naive as bad as a wet behind the ears med student
    Worse a waste of desperately short clinical time
    Is there some strange gas in London that makes people into utterly out of touch loons?
    NHS best system but the worst led
    The whole lot of them should be sacked

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  • would you be so kind as to moderate the comment I am thinking of posting?

    NICEcleary inhabit a parallel universe.
    Well done Dr Green. If someone else can do it , then they should do it.

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  • bring back GPPAQ!
    bring back GPPAQ!
    bring back GPPAQ!

    is on the list of things you never hear on the junior doctor picket lines.

    well, time for the GPC to start the good fight and get GPPAQ back.

    GPPAQ was a "validated" tool - this BMI recording is just nonsense.

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  • Strange, I've always had almost 90% of the population with coded BMIs even without QoF incentives. I do it as a habit. So they're going to pay for it now! I like that though it is quite a silly target to put knowing that we already have Obesity lists.

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