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NICE: Regular lifestyle advice for overweight adults should be in QOF

NICE has proposed that GP practices are incentivised to give ’appropriate weight management advice’ to all overweight patients every five years.

The proposed indicators will see QOF points awarded for practices that record BMIs every five years in all adults – and to give weight management advice in those recorded as overweight within 90 days.

The move, launched for consultation today, is part of a raft of new recommendations for QOF from NICE experts.

They include two on previously mooted annual reviews of anticoagulation therapy in patients with atrial fibrillation and a tightening of glucose targets for patients with diabetes.

NICE has also published a new list of performance indicators that it has developed for ‘quality improvement’. These include practices monitored for doing yearly pulse checks in patients at risk of atrial fibrillation.

But the GPC said that general practice was ‘full’ and should not be asked to take on any new QOF work.

Dr Andrew Green said: ’The GPC will comment on the individual indicators in due course, but our overriding view is that general practice in England and Wales is in such a state of emergency it would be inappropriate to introduce any new QOF indicators.’

 

What new indicators is NICE proposing for the QOF?

  • % of patients 18 or over with a BMI recorded in the preceding 5 years
  • % 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
  • % of patients with atrial fibrillation and a CHA2DS2-VASc of ≥2 at any time who are not currently treated with anticoagulant therapy who have had a review of the risks and benefits of anticoagulation in the preceding 12 months
  • % of people with AF prescribed anticoagulation who have a review in the preceding 12 months
  • % of patients with diabetes in whom the last IFCC-HbA1c is 53 mmol/mol or less in the preceding 12 months
  • % of patients with diabetes in whom the last IFCC-HbA1c is 58 mmol/mol or less in the preceding 12 months
  • Of the patients with type 1 diabetes who meet the following criteria: aged over 40 years and who have either had diabetes for more than 10 years, or who have established nephropathy or other CVD risk factors; the percentage currently treatment with a statin

Readers' comments (19)

  • Here we go... More box ticking GP nonsense

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  • I know how to really annoy fat people.
    Remind them they are fat every time they attend the GP-that should really enhance the doctor patient relationship!
    Idiots

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  • IDIOTS, Sometimes I wonder on what grounds people are selected to be on NICE committees? Do they think that we don't do it already? . If they have guts they can advice govt on increasing taxes on sugars and sugary food/drink.

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  • 10.38. Lol at "If they have guts" - sorry Pradeep just appreciating the irony.

    All across the country, Public Health Departments which are now under Local Authority control, are cutting their weight management service provision. There is no point in telling overweight people to eat less, it simply does not work. It's like telling an addict to just stop taking drugs. People need help with these things however hardline we might feel about it. And Pradeep's point about taxing bad food is absolutely right but of course the government does not want to upset the food lobby. Local authorities are also weak. Planning Departments will prevent you from improving your home but don't seem to stop high streets being rammed full of gambling dens and fast food outlets.

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  • In 25 years I haven't ever thought of telling obese patient to lose weight.......

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  • @Anonymous | GP Partner02 Feb 2016 11:52am

    'In 25 years I haven't ever thought of telling obese patient to lose weight.......'

    There is a time, a way and a place to tell people they are fat but never doing so is against being a GP.

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  • What if the patient is happy being over weight and does not consent to or want appropriate advice? An excellent way to alienate patients.

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  • I think you might be missing the potential upside of this. Yes, it's another box to tick, to confirm work already being done and not currently funded...

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  • Dear Liz,
    Apart from the obvious nonsense that this proposal is; be under no illusion there will be no new money for this. And if its put into QUOF then whatever they move out to make room for it will still be expected to be done even when its no longer being paid for.
    There is no upside to adding things to QUOF.
    Regards
    Paul C

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  • Do you think that next we will only get paid if the obese people we measure the BMI for, then loose weight? We only get paid on result?
    Just measuring BMI is pretty meaningless. Anyone can get a rought result just by knowing their weight and height as there are dozens of BMI calculators on the internet.

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