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NICE mulls change to QOF blood pressure targets

By Lilian Anekwe

Blood pressure targets in the quality and outcomes framework could be set to change as NICE seeks to align the targets with its own guidance, Pulse can reveal.

The latest minutes of the NICE QOF advisory committee show it will look into the possibility of ‘unifying' the blood pressure targets in the QOF with those set in NICE and SIGN guidance, following pressure from stakeholders.

Minutes from the committee's latest meetings state: ‘Stakeholders suggest the unification of blood pressure targets for patients with chronic kidney disease, diabetes, proven cardiovascular disease, and any combination of these.'

A spokesperson for NICE told Pulse the review was ‘still in early stages of development so we do not have an exact timescale yet'.

The current QOF sets different blood pressure targets for different conditions. GPs are incentivised to treat patients with coronary heart disease to 150/90mmHg, while the target stands at 145/85mmHg for type 2 diabetes and 140/85mmHg for patients with chronic kidney disease.

But NICE guidance recommends that GPs aim for a blood pressure target of 140/80mmHg for most patients with type 2 diabetes and an even tougher 130/80mmHg for those with other risk factors. The NICE guidance on chronic kidney disease recommends a target of 140/90mm Hg.

Dr Terry McCormack, former chair of the Primary Care Cardiovascular Society and a GP in Whitby, Yorkshire, said that while it was sensible to unify the QOF with NICE, GPs would still need audit targets.

‘It's crazy to have lots of numbers knocking about so it makes sense to coordinate the targets,' he said.

‘But you still need to have a difference between optimum targets and audit targets. The QOF committee will have decide whether it wants people to go for an optimum target but set a threshold that reflects that, or have an audit target that more practices can achieve.'

‘I think using audit targets is the better approach but the fear is that GPs will give up when they reach it.'

NICE is planning to 'unify' blood pressure targets NICE is planning to 'unify' blood pressure targets