QOF targets for cardiovascular diseases, including BP/hypertension, CHD and peripheral artery disease, make up almost 20% of QOF funding, but only 10% of the total NHS budget.
* Cardiovascular diseases include BP/hypertension, CHD peripheral artery disease. Mental health includes depression. Cancer includes cervical screening.
Greater QOF funding for certain disease areas may be warranted in some cases, particularly if they encourage preventive treatment and cut downstream costs.
But other areas are seemingly under-resourced. Obesity consumes £5bn in direct NHS costs (4.6% of the NHS budget), yet has been allocated just £9m (0.9%) of QOF funding.
This mismatch lends support to calls from public health expert Sir Michael Marmot for a greater number of public health-orientated indicators in QOF.
|
Disease areas |
QOF points |
QOF cash |
% of QOF |
NHS costs |
% of NHS budget |
| Cardiovascular disease* |
178 |
£192,932,428 |
20% |
£11.5bn |
10.5% |
| Diabetes |
107 |
£122,152,484 |
12% |
£13.8bn |
12.8% |
| Smoking |
75 |
£85,620,900 |
8% |
£5bn |
4.6% |
| Mental health* |
71 |
£81,054,452 |
8% |
£6.6bn |
6.1% |
| AF & stroke/TIA< |
49 |
£55,938,988 |
5% |
£2.8bn |
2.6% |
| Asthma |
45 |
£51,372,540 |
5% |
£1bn |
0.9% |
| COPD |
35 |
£39,956,420 |
4% |
£800m |
0.7% |
| CKD |
32 |
£36,531,584 |
4% |
£1.5bn |
1.3% |
| Cancer* |
33 |
£36,340,704 |
4% |
£5.2bn |
4.7% |
| Heart failure |
29 |
£33,106,748 |
3% |
£2.2bn |
2.0% |
| Dementia |
26 |
£29,681,912 |
3% |
£1.4bn |
1.2% |
| Rheumatoid arthritis |
18 |
£20,549,016 |
2% |
£700m |
0.6% |
| Osteoporosis |
9 |
£10,274,508 |
1% |
£1.7bn |
1.6% |
| Obesity |
8 |
£9,132,896 |
1% |
£5bn |
4.6% |
| *Cancer includes cervical screening; mental health includes depression; cardiovascular disease includes BP/hypertension, CHD and peripheral artery disease | |||||
| Sources: DH, NICE, National Rheumatoid Arthritis Society, Kerr et al 2012, Allender et al 2009, British Heart Foundation, NHS England, UK National Screening Committee, Kanavos et al 2012 | |||||
