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QOF set for new asthma and diabetes indicators

By Lilian Anekwe

New QOF indicators on asthma reviews and tests of diabetes foot sensation are likely to be cost effective and workable in general practice, according to the results of the first pilots to be run as part of the NICE-led process.

NICE advisors scrutinised the results of the pilots at a meeting in Manchester earlier this month, ahead of announcing which of the successfully piloted indicators will be included in the menu of QOF indicators and negotiated on by the GPC and NHS Employers this autumn.

A new indicator on the percentage of patients with asthma who had a review in the last 15 months was deemed likely to be cost effective.

The six month pilots, run in 32 UK practices, found that mean achievement in the indicator rose from 26.4% to 32.5% at the end of the six month pilot period.

Health economists from the University of York found that the indicator had an overall net benefit – estimated as the monetised benefit of the cost of delivering the intervention and the price of the QOF payment – of 0.002, the equivalent of one quality-adjusted life year gained for every 500 patients reviewed.

Indicators on the percentage of people with type 2 diabetes who had a record of a test of foot sensation in the previous two months, and the percentage in whom foot sensation had been risk assessed in the previous 15 months.

The QOF committee at NICE heard that a cost effectiveness analysis had found the savings were likely to be in the order of £50 for every patient.

Dr Colin Hunter, a GP in Aberdeen and chair of the QOF indicator advisory committee, said: ‘The science of cost effectiveness has to some extent to be done on the hoof. It's very complex and there are a lot of issues around it. There is not a huge amount of data on cost effectiveness.

‘Because it fairly rudimentary we have to make a balanced decision across all something. If there are no cost effectiveness data, that does not necessarily preclude an indicator progressing forward.'

QOF set for new asthma and diabetes indicators


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