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GP experts welcome new QOF dementia targets

By Lilian Anekwe

GPs look set for a strengthened role in managing dementia after NICE advisers proposed an indicator for giving patients a full health check among a package to be negotiated on for next year's QOF.

Health checks would go much further than the current requirement for an annual review, including tests for full blood count, calcium, glucose, renal, liver and thyroid function, plus serum vitamin B12 and folate levels.

GP dementia experts said the indicator would help improve diagnosis of the disease and identify patients with a treatable cause.

NICE's independent QOF indicator advisory committee included it among six proposed indicators for managing patients with schizophrenia, bipolar affective disorder and other psychoses, one for prescribing in patients with a previous myocardial infarction and two on diabetes-related foot care.

NHS Employers and the GPC will negotiate over the menu of proposals and decide which will be included, and what thresholds and points they will carry. Agreed indicators will come into force next April.

NICE has also expanded its list of indicators proposed for retirement, as it looks to accelerate its redevelopment of the QOF. Indicators for CHD, diabetes, asthma, epilepsy and serious mental illness all in line to be scrapped.

The proposals will leave practices faced with substantial new work for the same money, although GPs said the dementia testing at least most practices would already be doing.

Dr Bill Beeby, a GP in Middlesborough and chair of the GPC's clinical and prescribing subcommittee of the GPC, said: ‘It's quite likely a substantial number of GPs believe already that this is good practice for patients with dementia. We've been doing it for the last couple of years as part of the process you go through before referring patients to secondary care. Now patients will know everyone is going to be doing this work to a high standard.'

Dr Helena McKeown, a GP in Wiltshire and chair of the BMA's committee on community care, said: ‘The change would be a good thing for patients because it will help to diagnose more cases. We are living longer and there will be a time soon when about 20% of 85-year-olds will have dementia.'

Dr Colin Hunter, QOF advisory committee chair, said: ‘I'm confident these potential new indicators for the 2011/12 QOF, together with our recommendations on which indicators which can be retired, will drive up quality of care across general practice.'

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