DoH looks at impact of axing QOF indicators

Evidence of the impact on patient care will be needed before indicators are removed from the quality framework (QOF), a DoH adviser has warned.

Speaking at the NICE annual conference in Manchester last week, GP Professor Helen Lester discussed the DoH's plans to retire quality indicators as others are introduced.

'We don't know what happens to achievement levels when you take indicators out of a system,' she said.

'We need to know that before we rush and decide to just take indicators out of the QOF.'

Professor Lester and her team are examining achievement levels with and without financial incentives for four indicators covering diabetes and hypertension that appear in both the QOF and US systems.

Results are expected to be available early next year.

Speaking to GP after the conference, Professor Lester said the findings would be important whatever was found.

'Whether performance slides or stays the same, there will be policy implications,' she said.

Professor Lester's team is also comparing achievement across indicators in the QOF.

'We will be actually able to say what happens to these other sorts of differently incentivised areas,' she said. 'When we have that information at least we're not just giving our best guess.'

GPC member Dr Simon Poole said he could not see a situation where there would not be a fall in the achievement for indicators that are no longer incentivised.

Practices see the QOF as a resourcing support for a framework of structured care, he pointed out.

'Even though indicators have become part of normal practice, there will not be the resourcing support for the structured population care,' he said.

'I fear that removal of some of the indicators will absolutely cause practices to refocus attention.'

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