NHS England will consider updating a QOF CVD target to align it to less stringent new NICE recommendations.
Last month, NICE set a target for cholesterol levels in secondary prevention of cardiovascular disease (CVD) for the first time.
GPs are now advised by NICE to keep patients’ LDL cholesterol levels at 2.0 mmol per litre or less, or non-HDL cholesterol levels at 2.6 mmol per litre or less.
However, targets set out in QOF are for a non-HDL cholesterol of less than 2.5 mmol/L, or where this is not recorded, an LDL cholesterol in the preceding 12 months that is lower than 1.8 mmol/L.
The NICE committee said for many patients ‘the QOF target is not being met’ with figures from June suggesting that only 28.7% were meeting the target.
In its latest primary care bulletin, NHS England reassured practices that meeting the QOF target for cholesterol levels, which are lower NICE guidelines, does not carry clinical risk.
Pointing to NICE’s new guidance, NHSE said: ‘As a result, for the remainder of 2023/24, there will be a slight difference between NICE and QOF cholesterol targets.
‘Complying with the QOF (CHOL002) targets will not carry a risk of over treatment. The slightly higher target levels chosen by NICE are based on considerations of cost-effectiveness, rather than clinical risk.
‘NHS England will consider any potential changes to future QOF arrangements as part of the usual annual review process.’
NICE has predicted that the new recommendations could impact up to 2.1 million people with CVD.
Analysis of figures from the Office for Health Improvement and Disparities (OHID) showed that between June 2022 and June 2023, excess deaths involving CVDs for 50- to 64-year-olds were 33% higher than expected.
In November, the Government’s chief medical officer said responsibilities around CVD prevention should be extended beyond general practice.
And last month, a group of charities and professional organisations called for GP incentive programmes to be aligned with clinical guidelines for testing and treatment of CVD and CVD-risk conditions.
GP leaders recently said NICE is ‘out of touch’ with the reality of general practice in a motion at the England LMCs conference which called for ‘good enough’ standards rather than ‘unrealistic gold standards’.
Before Christmas, the Government launched a public consultation on the future of QOF, asking for views on whether the scheme should be scrapped.
