'Cut AF quality points for obesity'

Depression and AF should be axed from the quality framework to free up an extra 22 points for obesity indicators, a leading GP has suggested.

Dr David Haslam, clinical dir­ector of the National Obesity For­um and a GP in Hertfordshire, said the quality framework should incentivise GPs to treat obesity.

Dr Haslam said it would be ‘unethical and bordering on negligence’ if GPs did not treat obese patients.

‘Depression and AF are important areas, but just not as prevalent as obesity,’ he said.

‘All we do for obese patients is to take a register, which is a catastrophic failure and is of no clinical benefit at all.

‘We should be screening pat­ients for diabetes, hypertension, stroke and heart disease.’

Weight management and an obesity register for children below the age of 16 should be added to the quality framework to bring the total number of quality points for obesity to 30 points, he said.

Currently, the obesity domain, introduced in 2006/7, carries just eight points.

But North Shields GP Dr Dave Tomson, who has an interest in mental health, argued that  it would be a ‘retrograde step’ to lose depression from the quality framework.

‘Depression adversely affects as many clinical areas as obesity does,’ he said.

Dr Tomson added that there was more evidence to show the benefits of using anti-depressants in treating depression than for using obesity drugs to treat obesity.

Dr Chris Manning, chief executive of the charity Primary Care Mental Health and Education, said high prevalence alone was not a reason to expand obesity points.

‘Why not get rid of both obesity and depression in favour of ear wax syringing — that’s even more common,’ Dr Manning pointed out.

‘Frankly, I don’t think GPs should be allowed anywhere near obesity.’

‘I think the idea of incentivising better eating behaviours through loyalty and other reward systems would be far more beneficial,’ he added.

Surrey GP Dr John Pittard, a member of the Primary Care Cardiovascular Society, said
that he would be reluctant to drop AF from the quality

However, Dr Pittard agreed that the obesity domain should be expanded.

‘GPs do check obese patients for lipid levels and BP up to a point, but we do not actively pursue them,’ he said.

GPC chairman Dr Laur­ence Buckman said there would be no change to the quality indicators for obesity in 2008/9.

‘Obesity is not on the list of changes that we are looking at,’ said Dr Buckman.

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