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Outrage as NICE urges Government to drop QOF depression indicators

Campaigners have urged the Government to step in and protect GP funding for mental health work, after NICE announced they would be recommending the removal of all indicators on depression from QOF.

This week NICE published their final recommendations for changes to QOF in 2011/12 that will be negotiated by NHS Employers and the BMA, including the removal of all three depression screening indicators.

The menu also includes adding three new indicators on smoking, two on promoting physical activity and a set of indicators on fragility fractures in osteoporosis patients (see below for full list).

Pulse revealed last month that NICE was considering removing the indicators on depression, after a number of complaints about the indicators from GPs. However, campaigners are demanding the Government looks at other ways of incentivising practices to focus on mental health.

In a letter to GPC negotiators, Sir Andrew Dillon, chief executive of NICE, said there were 'significant concerns' over the quality of supporting evidence for the three depression indicators.

'The Advisory Committee noted there was published evidence that GPs have concerns that the indicators have unintended consequences on the care provided to people with depression by encouraging what they describe as a more bureaucratic approach to identifying depression, at the expense of more engaged screening,' he said.

But Dr Ian McPherson, chief executive of the Mental Health Providers Forum, was dismayed by the message it would send if QOF indicators for depression were dropped without a review.

He said: ‘A decision simply to remove the QOF indicators for depression, rather than reviewing or strengthening them, would give the unfortunate message that there is no need to incentivise the treatment of one of the most disabling conditions in primary care for which effective interventions are increasingly available, but which still tends not to be as accurately identified as conditions which do not carry the same level of social and personal discrimination.'

Steve Shrubb, director of NHS Confederation's Mental Health Network said: 'We are extremely concerned about proposals that, if enacted, would remove any financial incentives to identify the most common form of mental illness in GP surgeries.'

'Imperfect as the indicators are, our members think it would be reckless to remove the depression indicators from the GP treatment framework until suitable alternatives are in place,' he added.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, also said: ‘Removing QOF incentives for GPs to identify and help patients with depression would not only represent a significant backward step in the treatment of mental illness in this country, but would renege on the pledge made in the coalition's mental health strategy to treat mental health problems as of equal importance to physical illnesses.'




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