GPs face public health challenge in 2012/13 QOF

GPs could have to undertake a raft of public health interventions as part of QOF after NICE proposed five indicators targeting smokers and inactive patients.

Less active hypertensive patients would need to be assessed (Photograph: SPL)
Less active hypertensive patients would need to be assessed (Photograph: SPL)

The measures, proposed last week by NICE's Primary Care QOF Indicator Advisory Committee, are in line with the government's aim to dedicate 15 per cent of QOF to public health outcomes.

The recommendations will pass to negotiators for potential inclusion in the 2012/13 QOF.

Advisers at the two-day meeting in London put forward 20 new indicators and recommended retiring four indicators. Under the public health measures, GPs would be paid based on the proportion of smokers aged over 15 years who are offered support and treatment.

Patients with peripheral arterial disease would be added to existing smoking indicators.

GPs would be paid to assess and offer a brief intervention to hypertensive patients deemed 'less than active' using the General Practice Physical Activity Questionnaire.

But the committee rejected new obesity indicators for measuring waist circumference and referral to a weight management programme.

Pilots of the new indicators had been mainly positive but some committee members said the indicator would be merely a 'tick box' exercise.

Committee chairman Dr Colin Hunter said further research into the benefits of such measures was needed.GPs are also set to offer structured education and dietary review to patients with diabetes.

Diabetes UK welcomed the new indicators but said clinicians must follow NICE guidance when implementing them.

QOF Changes

IN - proposed new indicators

  • Asthma: review
  • AF: assessment and treatment for stroke risk
  • Physical activity: assessment and intervention for hypertensive patients
  • Primary prevention of cardiovascular disease: statins for new hypertension diagnosis
  • Osteoporosis: register and treatment
  • Peripheral arterial disease: register, diagnosis, treatment and BP reading
  • Diabetes: structured education and dietary review
  • Smoking: register and support or treatment for PAD smokers

OUT - indicators to be retired

  • Dep4: severity assessment
  • Dep5: further severity assessment
  • AF4: diagnosis
  • DM2: BMI record

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