GPs back increased clinical focus

Quality 72 points reallocated, clinical indicators topped up and sexual health added.

GPs have welcomed changes to the UK GMS contract for 2009/10 that strengthen the clinical values of the quality framework.

NHS Employers and the GPC have agreed changes that will see 72 quality framework points reallocated, mostly from two patient experience indicators, to boost clinical care.

A new indicator worth nine points will be added to the heart failure (HF) domain, which moves the current HF DES for England into the framework.

Professor Martin Roland, one of the architects of the quality framework, said that it seemed logical for the HF DES to become part of the framework.

But it does not necessarily mean more money for GPs to carry out the work, he warned.

Two indicators will be added to the cardiovascular disease (CVD) domain. These indicators will focus on measuring CVD risk using a risk tool and offering lifestyle advice to patients with newly diagnosed hypertension.

Dr Terry McCormack, former chairman of the Primary Care Cardiovascular Society and a GP in North Yorkshire, said extra HF and CVD points were 'great news'. 'This is high-quality care that GPs should be delivering, and will help to bring all practices into line.'

Ben Dyson, DoH director of primary care, said at a briefing this week that the hypertension indicators would be used to identify at-risk patients who should be offered a vascular risk assessment.

Sexual health has been added to the framework for the first time. Three indicators will offer 10 points to practices producing a register of women who have been prescribed contraception at least once a year and have received information about long-acting reversible contraceptives (LARCs).

RCGP vice-chairwoman Dr Clare Gerada, who has an interest in sexual health, said: 'It is a good move to have family planning in the framework. The indicators will get GPs to discuss contraception and promote the use of LARCs.'

GPC negotiator Dr Chaand Nagpaul said: 'Our first aim was to retain the value of the quality framework at a time when there are threats to reduce the points.

'The government wanted to disinvest in the patient surveys and merge them in with postal access surveys, so we felt this could free up points for clinical indicators.'


Changes to quality framework for 2009/10
What's in

  • Heart failure: 9 points
  • CKD: 11 points
  • Sexual health: 10 points
  • Anxiety and depression: 20 points
  • CVD: 13 points
  • Diabetes: 7 points
  • COPD: 2 points

What's out

  • Patient experience: 55 points
  • Smoking: 8 points
  • BP: 2 points
  • CHD: 2 points
  • AF: 3 points
  • Contraception: 2 points

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