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GPs set to be incentivised for referrals to talking therapies as NICE endorses QOF indicator

Practices could be incentivised to refer more patients with depression and anxiety for talking therapies under a new QOF indicator rubber-stamped by NICE advisors, despite opposition from the GPC and RCGP.

The indicator – which will reward practices for referring patients within three months of diagnosis – was agreed at yesterday’s QOF indicators advisory board meeting in Manchester, after piloting showed the approach led to a big increase in referrals to psychological therapy services, from around 4% to 20% of patients.

The RCGP and the GPC had opposed the indicator on the grounds that many patients with relatively mild depression and anxiety do not need referral and that IAPT services are already over-stretched, while the coding and timing of diagnosis of both anxiety and depression can be uncertain.

However, NICE advisors said evidence showed GPs were not referring people to psychological services frequently enough – and that the codes for diagnosis would be expanded to capture symptom-based codes as well as firm depression or anxiety diagnoses codes.

The chair of the QOF/CCG outcomes indicator advisory panel, Professor Danny Keenan, told Pulse the indicator would help drive an expansion of IAPT services.

Professor Keenan said: ‘It will drive development of the psychological therapies. We obviously need more facility but this is what will drive an increase in facilities.’

In the same meeting, the panel decided to recommend the inclusion of a new QOF indicator rewarding practices for how many patients they treat with statins at the 10% primary prevention threshold, despite unease among GP members on the independent advisory panel.


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