Exclusive: Ministers have asked NICE to look at introducing a new public health domain in next year's QOF, as part of moves to ring-fence 150 points for preventing disease and tackling healthcare inequalities.
The new domain is being negotiated by NHS Employers and the GPC for introduction in April 2013.
Discussions are focusing on which indicators should be included, but the GPC is insisting the domain must be made up solely of existing QOF indicators shifted into the new public health section.
GPC deputy chair Dr Richard Vautrey said: ‘Practice activity will remain unchanged. It shouldn't make it tougher. The QOF will continue to remain evidence-based.'
Dr Bill Beeby, the GPC's prescribing lead, insisted there was plenty of scope to redesignate enough existing QOF points: ‘A lot of the QOF is already "public health" – looking at health interventions on a mass scale with the intention of producing long-term population gains. Such is the reasoning behind statins.
‘If they are going to introduce other measures, there needs to be good science behind it, and that might stall some of the more vague ideas.'
But Professor Helen Lester, clinical QOF indicator development lead, predicted attention would focus on ‘obesity, smoking, physical activity and alcohol'.
An NHS Future Forum report published in January made a strong case for tougher public health targets in the QOF, calling for GPs to ‘make every contact count' in tackling these four big lifestyle risk factors.
The report said: ‘Some incentives do not sufficiently target improved population health and wellbeing. The QOF rewards GP practices for keeping a register of obese patients. It does not go further and reward practices for supporting patients to eat more healthily, exercise more or access weight-loss support.'
A Department of Health spokesperson said the proposal for 15% of the QOF to be devoted to public health had been set out in a 2010 white paper: ‘We have discussed this proposal with NICE, and NHS Employers are now consulting with the GPC about setting up the domain including which indicators will be included in April 2013.'
All indicators will pass through the NICE QOF advisory process.
