Quality framework points lost from COPD indicator

Changes to the COPD and chronic kidney disease (CKD) domains of the quality framework came into force this week, but for no extra income.

Under the 2008/9 quality framework, which came into force on 1 April, GPs will be expected to diagnose COPD using post-bronchodilator spirometry, rather than reversibility testing.

As a result, the COPD diagnosis indicator is worth five quality points rather than the previous 10.

But Dr John Haughney, president of the International Primary Care Respiratory Group and a GP in Glasgow, said: ‘Diagnosis is the bedrock of disease management and I don’t agree that points should be reduced.’

While post-bronchodilator spirometry is key for assessing severity of COPD, he added: ‘I would encourage people to do reversibility if they need that to make a positive diagnosis.’

Other adjustments to the quality framework, released just four days before GPs were expected to implement them, included proteinuria tests in CKD.

This follows on from NICE draft guidelines on CKD released last month, which called for proteinuria tests to gauge if patients are to be given ACE inhibiors or angiotensin receptor blockers (ARBs).

rachel.liddle@haymarket.com

www.bma.org.uk

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