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Rise in asthma prevalence under QOF 2019/20 ‘prompted by Covid-19’



The prevalence of asthma increased under the Quality and Outcomes Framework (QOF) in 2019/20, with GPs suggesting a ‘rush’ for inhalers at the start of the pandemic contributed to the rise.

In QOF data released yesterday by NHS Digital, the recorded prevalence of asthma was up 0.42 percentage points in 2019/20, to 6.5%, compared with figures from 2018/19.

Similarly, the prevalence of obesity also increased under the QOF last year, up by 0.37 percentage points to 10.5%.

Depression saw the largest change in recorded prevalence, up 0.8 percentage points to 11.6%, however this is thought to be because patients diagnosed since 2006 continue to be added to the register.

Hypertension recorded the highest prevalence rate at 14.1%, but only changed year on year by 0.11 percentage points.

Swindon GP and QOF expert Dr Gavin Jamie suggested patients trying to get hold of an inhaler prescription in light of the pandemic could have had an effect on the QOF figures.

He said: ‘Asthma has been pretty steady through the years. There did seem to be a bit of a rush for inhalers in March, which was probably Covid related, so that may have an effect on this as patients need both a diagnosis and prescription so this could have boosted numbers on the register.’

Asthma UK’s head of health advice, Emma Rubach, also said the increase in asthma prevalence under the QOF could be down to the pandemic ‘prompting’ patients to secure prescriptions.

She said: ‘Whilst population increases and changes might be a contributory factor, we have heard anecdotally from GPs that coronavirus has prompted people with asthma to take more of an active interest in their condition and its management, including a rush to get prescriptions, especially at the start of the pandemic.’

Commenting on the rise in obesity prevalence, Dr Jamie noted the figures appeared to genuinely show an increase in people who are overweight – but that practices are also improving their recording under QOF.

He added: ‘Obesity is only on measurements in the QOF year i.e. patients must have had a BMI of over 30 between April 2019 and March 2020.

‘That means that this is a real rise in the number of patients with a diagnosis, although this is probably as much about practices getting better at QOF and measuring as a rise in obesity in the population.’

However, he also said: ‘The number of patients diagnosed at practices is still quite a lot below the public health estimates.’

It comes as NICE recommendations for GPs to refer a quarter of all patients for weight management services could be introduced next year under the QOF, as part of the Government’s new obesity strategy.

This latest QOF data show GP practices earned fewer points on average under the QOF payment system last year compared with 2018/19 – but achievement was still high.

NHS England has said it will top up a practice’s QOF earnings to the previous year’s cash level if they underperformed due to focussing on Covid-19 work.

But practices are still expecting to miss out on thousands of pounds in money for 2019/20 they had initially been budgeting for, because the top-up up will match last year’s cash level, without taking into account the increase in value for each point this year.

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