BP checks for hypertension in QOF 'may be costly for GPs'

Ambulatory BP monitoring for diagnosing hypertension could be added to the QOF from 2014/15, but a senior cardiac GP warned the change could prove expensive for practices.

BP monitors: GPs face costs (Photograph: SPL)
BP monitors: GPs face costs (Photograph: SPL)

NICE will consider the proposal at a meeting in Manchester later this month. It comes after NICE advised GPs to use monitoring devices to confirm hypertension diagnosis in gui­dance published last summer. The indicators could enter the QOF in two years’ time if piloting is successful.

North Yorkshire GP Dr Terry McCormack, who worked on the NICE guidance, told GP a QOF target would improve practices’ adherence to the new standard.

‘By using these devices we can make quicker and more accurate diagnosis, saving doctors and nurses val­uable time overall.’

He added that costs had fallen ‘considerably’ and will drop further making the devices ‘affordable for all practices’.

Burden on primary care
Cambridgeshire GP Dr Mike Knapton, associate medical director at the British Heart Foundation, said NICE must carefully consider the burden on primary care resources.

‘Most GP practices do not have access to in-house 24-hour monitoring. It would mean either GPs buying them or it would drive referrals to secondary care.’

NICE must be clear whether GPs would use ambulatory 24-hour monitors costing £500 or more, or home monitoring kits costing around £20. Buying the former for every UK practice may cost more than £5m, he warned.

Dr Knapton added: ‘Accurate diagnosis of high BP is what we’re interested in. We should leave it to GPs how best to diagnose hypertension.’

NICE advisors will also discuss new targets for alcohol and dementia, and consider results of pilots of indicators for 2013/14, including for rheumatoid arthritis and asthma.

Existing indicators in 20 clinical areas will be under review, inc­luding asthma and obesity.

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