By Lilian Anekwe
NICE has taken the first steps in transforming the QOF to include more outcome measures, by agreeing to develop an indicator rewarding GPs for how many patients turn up at structured education classes.
The independent QOF indicator advisory committee plans to develop and pilot an indicator for the number of newly diagnosed patients with diabetes who show up for condition-specific structured education programmes.
The decision, taken at its meeting in Manchester last week, came after NICE recommended the topic be progressed for indicator development to try and improve attendance at the programmes, particularly in black and ethnic minority groups.
It is thought these indicators, if successfully developed, piloted and included in the menu for the QOF, could be used as a yardstick for future inclusion of more outcome measures in the QOF – a major coalition Government priority. But the move is set to be controversial, since it places GP pay at the mercy of patient behaviour.
The committee discussed developing three potential indicators, one incentivising the offer of a structured programme, and another actually for making a referral.
But a third outcome indicator would pay GPs for the number of patients who attend, but with a low threshold, to acknowledge attendance and completion rates are likely to be poor.
Dr Colin Hunter, a GP in Aberdeen and the chair of the committee, admitted there was likely to be resistance from GPs: ‘I think if we went for indicators for having attended it is likely it will fail. It’s a bit like smoking or drinking. You can advise patients but you can’t force them to stop. My preference is that we incentivise for referral.’
NICE will develop new diabetes indicators for piloting