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