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NICE should develop new quality metrics for GP practices, recommends review



GP practices are facing the publication of a new set of performance indicators on the quality of their care, under proposals published today by a Government-commissioned review.

The report, led by Dr Jennifer Dixon of the Health Foundation, recommends that patients and NHS managers should be able to easily view how a practice is performing in comparison with others, including those with a similar profile.

The indicators would include data already in the public domain, such as CQC ratings, NHS Choices and Public Health England practice profiles, which would be consolidated on a single website.

But the report also recommends NICE develops new metrics to measure GP practices, similar to the work it does developing indicators for the QOF.

The authors do not recommend what the final indicators should be, but they recommended ‘development, potentially by NICE with others’ of a small set of indicators that show information about ’what matters most to the public, healthcare professionals and those accountable for the quality of general practice’.

The report was first announced by health secretary Jeremy Hunt in his ‘new deal’, in which it was mentioned that the Health Foundation would be doing the background work for the development of a ‘scorecard’ for practices.

But the report wholly rejects giving practices an overall rating, and it says that such measurements will not form a ‘scorecard’, adding that the term is ‘divisive’.

Pulse revealed earlier this year that RCGP had said it would not engage with the consultation unless plans for a ‘scorecard’ were dropped.

Dr Dixon told Pulse: ‘The first thing would be to consolidate the data and that NICE helps to develop the set of indicators that we have got already. At the moment, it is unclear how the indicators are developed and they need to be linked to some kind of quality improvement strategy as well.

’We think that NICE could convene a number of stakeholders to do that well, a bit like they do already for the QOF, but to expand that.’

Dr Dixon said that the metrics should be ‘value-free’, showing performance compared with the average practice and those with similar profiles.

The Government has been pushing for its new ‘MyNHS’ website to include data on all healthcare providers, and it included the CQC’s ‘intelligent monitoring’ rating for GP practices, which was later withdrawn after problems were found with the data.

The Health Foundation says that ‘the direction of government policy is towards establishing MyNHS as the primary portal for information about the quality of health and care services’.

It says that, if MyNHS were to be used for this purpose, the Government would need to conduct further market research ‘given the limitations of the MyNHS website’.

The report said: ’The term ”scorecard” is divisive – we recommend avoiding this terminology if a key purpose is for improvement. There appears to be low awareness, among GPs in particular, of the main websites currently containing quality indicators for general practices.’