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Quality premiums must be piloted, says NICE

By Lilian Anekwe

NICE has told ministers they should pilot introduction of quality premiums to make sure they are a fair and reliable way of rewarding GP consortia.

The Department of Health plans to pay GP consortia quality premiums based on their hitting a series of clinical outcome targets and controlling their budgets.

But the institute warns in its official response to the consultation on the DH’s white paper that it might ‘be a challenge’ to demonstrate that achievement of patient outcomes is a result of decisions made by GP commissioners.

The NICE response details a series of concerns, first reported by Pulse earlier this month, that ‘there will be real difficulty in switching to outcomes as there are issues of confounding that will limit their usefulness’.

‘Improvement or deterioration in commissioning outcomes might in part be due to changes in the contribution of other services, such as public health and social care, or in local social and economic factors,’ its document says.

The institute urged health secretary Andrew Lansley to pilot the system of paying quality premiums, to ensure they will be ‘resource neutral’.

‘We suggest the quality premium be carefully phased in and evaluated. Our suggested pilot phase would enable cost assumptions to be tested.’

NICE said there was ‘a lack of valid, reliable outcome indicators’ in the commissioning quality standards it had already drawn up, and that it might be forced to revert to process measures: ‘It may be more important to examine case by case whether it would be sufficient to use an indicator of process with an evidence-based connection with an outcome.’

NICE response: Transparency in outcomes NICE response: Local democratic legitimacy in health NICE response: Commissioning for patients Read the full response from NICE

Read the full responses from NICE:

Transparency in outcomes
Local democratic legitimacy in health
Commissioning for patients

Video: ‘You cannot measure a GP on long-term outcomes’

Quality premiums must be piloted, says NICE Take a pioneering role in the restructure of primary care

Equip yourself with the knowledge and skills to make your consortia a success at our first Practical Commissioning event of the year – ‘Consortia of the Future’ on 17 February in London and 3 March in Manchester 2011.
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