Depression rising faster than any other condition measured in QOF

Prevalence of depression rose faster than any other condition measured in the QOF last year, according to official data that show GP practices earned £92,000 on average from the framework in 2017/18.

GP consultation (Photo: iStock.com/MartinPrescott)
GP consultation (Photo: iStock.com/MartinPrescott)

One in eight GP practices in England achieved the maximum 559 points available in the QOF for 2017/18 - worth £95,701 to an average-sized practice. The average score nationwide was 537.5, with each point valued at £171.20, figures from NHS Digital reveal.

Prevalence recorded by GP practices was highest for hypertension, with 13.9% of patients affected, followed by depression (9.9%) and obesity (9.8%).

But prevalence of depression - recorded for patients aged over 18 - rose faster than prevalence for any other condition measured in the framework in 2017/18, increasing from 9.1% in 2016/17 to 9.9% in 2017/18.

Depression prevalence

GPC chair Dr Richard Vautrey warned that the increase was having a 'big impact' on GP practices - particularly because rising prevalence was not being matched by community-based mental health services.

In some CCG areas, as many as one in six patients registered with GP practices are now recorded as having depression - with NHS Blackpool CCG, NHS Heywood Middleton and Rochdale CCG and NHS Wyre Forest CCG all facing prevalence in excess of 15%.

The north of England region as a whole saw the largest increase, with a 0.9% rise to 11.1% prevalence across the area - but prevalence of depression rose in all regions of the NHS. Just five CCGs in England recorded a reduction in prevalence of depression in 2017/18 compared with 2016/17.

The proportion of GP practices in England achieving maximum QOF points has increased sharply in recent years, the data show.

In 2014/15, fewer than 6% of practices achieved all 559 points available - compared with 12.5% in 2017/18. Exception rates were lowest for the blood pressure indicator group, while exception reporting was highest for cardiovascular disease primary prevention indicators.

QOF targets

Dr Vautrey said: 'Rising rates of depression are having a big impact on general practice. We are at the front end of providing mental health services.

'We heard in the budget about plans to invest £2bn for mental health services - we need to see a significant proportion of that invested in community-based services linked to general practice. Increasing prevalence is not being matched by a rise in availabilty of services such as IAPT and other services in the community - some patients are having to wait six months or longer to get basic services.'

GPonline reported earlier this year that almost half of GPs believe the QOF should be scrapped completely in England. The framework has been cut back significantly across the UK since it first took effect in 2005 and has been dropped altogether in Scotland - but looks set to continue for now in England.

NICE published details earlier this month of proposed new indicators that could be added to the QOF in England from April, including eight new diabetes targets.

Diabetes is already the indicator group that has the most QOF points attached to it - with 86 points available for diabetes targets in total in 2017/18.

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