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NICE publishes draft proposals for new £40m vaccinations QOF domain



NICE has launched a consultation on draft new GP vaccination indicators, which are to form a new QOF domain worth £40m.

The introduction of the new incentive payments, which will be paid to practices that achieve the required coverage for vaccinations and will replace the current childhood immunisation DES, was negotiated as part of the 2020/21 GP contract deal.

NICE’s consultation, which closes 15 July, proposes six new indicators, from childhoold to adulthood.

The proposed indicators are:

  • Dipetheriea, tetanus and pertussis: The percentage of babies who reached 6 months old in the preceding 12 months, who have received at least 3 doses of a diphtheria, tetanus and pertussis containing vaccine before the age of 6 months.
  • MMR (1st birthday): The percentage of children who reached 18 months old in the preceding 12 months, who have received at least 1 dose of MMR on or after their first birthday and before the age of 18 months.
  • MMR and diphtheria, tetanus, pertussis and poliomyelitis: The percentage of children who reached 5 years old in the preceding 12 months who have received a reinforcing dose of DTaP/IPV and at least 2 doses of MMR on or after their first birthday.
  • MMR (5th Birthday): The percentage of children who reached 5 years of age in the preceding 12 months who have received 1 dose of MMR on or after their first birthday.
  • Pertussis-containing vaccine during pregnancy: The percentage of women who reached 32 weeks of pregnancy in the preceding 12 months who have received a pertussis-containing vaccine after 16 weeks of pregnancy.
  • Shingles vaccine: The percentage of patients who reached 75 years of age in the preceding 12 months with a record of a shingles vaccine.

Swindon GP and QOF expert Dr Gavin Jamie said NICE’s list of indicators was ‘interesting’, as they are more likely than usual to make it into the QOF, due to the contractual agreement.

‘NICE seems to be responding to these with a range of possible indicators. These tally with the national immunisation programme and so are likely to be nodded through (with the possible exception of the 5yo incentive for a single dose of MMR). It may just be the MMR indicators in the first year as only MMR has been moved to the new system so far.’

He also commented that the pertussis indicator in pregnancy ‘while well intentioned’ would be ‘difficult to use in practice’ because ‘stages of pregnancy are not particularly well coded in practice systems’.

BMA GP Committee chair Dr Richard Vautrey said: ‘Immunisation is incredibly important and we would encourage all those eligible for vaccines to ensure they and their children are properly protected, not least as we continue to have to deal with this serious coronavirus pandemic.

‘These proposals for potential new QOF indicators will, as with any other NICE recommendations, be subject to future negotiations.”

QOF reporting is currently suspended due to the Covid-19 emergency but the BMA is in discussions with NHS England about whether GP practices will have to resume reporting before the end of the year.

NICE’s consultation also proposed draft new indicators for obesity, which could see GPs referring a quarter of all their patients to weight management services.

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