Changes to six clinical domains in the quality framework

Detail of changes to six clinical domains in the quality framework have been agreed on by the GPC and NHS Employers.

The domains are smoking, AF, CKD, palliative care, COPD and stroke and TIA.

Smoking indicators 1 and 2 become 3 and 4.

Smoking 3: The percentage of patients with any or any combination of the following conditions: CHD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses whose notes record smoking status in the previous 15 months.

Smoking 4: The percentage of patients with any or any combination of the following conditions: CHD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who smoke whose notes contain a record that smoking cessation advice or referral to a specialist service, where available, has been offered within the previous 15 months.

AF2 becomes AF4: The percentage of patients with AF diagnosed after 1 April 2008 with ECG or specialist confirmed diagnosis.

CKD4 becomes CKD5: The percentage of patients on the CKD register with hypertension and proteinuria who are treated with angiotensin converting enzyme inhibitor (ACE-1) or angiotension receptor blocker (ARB) (unless a contraindication or side -effects are recorded).

PC1 becomes PC3: The practice has a complete register available of all patients in need of palliative care/support irrespective of age.

COPD9 becomes COPD 12: The percentage of all patients with COPD diagnosed after 1 April 2008 in whom the diagnosis has been confirmed by post bronchodilator spirometry.

STROKE11 becomes STROKE13: The percentage of new patients with a stroke or TIA who have been referred for further investigation.

neil.durham@haymarket.com

NHS Employers

BMA website

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