NICE is proposing that hypertension indicators in the QOF differ by age for the first time, with differential blood pressure targets for patients aged below and above the age of 80.
The move follows a radical rewrite of NICE guidance on hypertension last August which set differential treatment targets for older and younger patients with antihypertensive drugs.
For patients aged 80 and over, the treatment target for systolic blood pressure was set at 150/90mmHg or lower, with antihypertensives indicated for those above 160mmHg, while for younger patients the target is now 140/90 or lower.
Similarly, the proposed new QOF indicators would reward GPs for a percentage of patients aged 80 and over with a measured blood pressure of 150/90mmHg or lower over the preceding nine months. The target for patients under 80 is 140/90 or lower.
There is a precedent - in 2009 NICE announced that hypertension indicator PP1 would only apply to patients aged 30 to 74.
A survey in Pulse last year found three out of four GPs supported the principle of putting more age caps in the QOF amid concern about over-treatment of elderly patients, although the BMA has expressed concerns about discrimination on the grounds of age.