GPs face fresh QOF overhaul in cardiovascular push

GPs could be hit by a new raft of QOF targets for cardiovascular diseases and will be asked to 'screen' more patients for the conditions under plans set out by the DH.

Health secretary Jeremy Hunt said the health of the UK had lagged behind Europe 'for too long'
Health secretary Jeremy Hunt said the health of the UK had lagged behind Europe 'for too long'

The DH has asked NICE to review QOF indicators in a bid to transform how the NHS detects and treats cardiovascular diseases.

GP practices will also be scrutinised on how many patients with cardiovascular disease they can detect, and face regular examination of the quality of care they provide.

The development comes as GPs already face much tougher QOF thresholds under DH plans for the 2013/14 GP contract.

The DH has also published a 'call to action' on reducing avoidable deaths, after a Lancet study found the UK's health outcomes lag behind many other European nations.

Health secretary Jeremy Hunt said improvements in care for cancer, heart, stroke respiratory and liver disease could save 30,000 lives by 2020.

New scrutiny on practice performance
The department's new Cardiovascular Disease Outcomes Strategy aims to rethink how the NHS prevents and treats the diseases.

It said that despite 'significant achievements' in care for cardiovascular disease over the past 20 years, further improvements are needed.

The DH wants commissioners to view conditions such as AF, stroke and heart disease as a single 'family' of diseases.

As part of its plans, GP practices will be benchmarked on the quality of care they provide for cardiovascular disease, and practice performance data will be published nationally. Efforts to case find more patients with the diseases will be stepped up.

The DH said despite QOF indicators for cardiovascular disease, AF patients are not always appropriately anti-coagulated, those with hypertension are not always well managed, and diabetes patients do not always get the nine basic care checks.

The strategy said: 'The NHS Commissioning Board (NHSCB) will work with stakeholders to identify how to incentivise and support primary care consistently to provide good management of people with or at risk of CVD.

'This will include DH asking NICE to review the relevant QOF indicators and promotion of primary care liaison with local authorities, the third sector and Public Health England to ensure optimal provision of prevention services, including secondary prevention.'

The NHSCB will develop 'new tools to support case finding in primary care', it said.

Other measures include:

  • An assessment of how the NHS currently cares for cardiovascular disease, including a greater emphasis on the related conditions as a 'family of diseases'.
  • A drive to improve uptake of the NHS Health Checks scheme.
  • Greater efforts to identify people at risk of inherited high cholesterol.
  • New public awareness campaigns for cardiovascular diseases such as stroke, greater access to and training in the use of defibrillators, and better patient access to treatment.
  • Developing new ways of assessing the needs of patients with cardiovascular disease, such as self-management, physiological and end of life care.

Researchers writing in the Lancet said that despite increases in health spending, the UK's efforts to reduce premature mortality had fallen behind the European average.

Launching the cardiovascular strategy and the call to action, Mr Hunt said: 'Despite real progress in cutting deaths we remain a poor relative to our global cousins on many measures of health, something I want to change.

'For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around. Today’s proposals for those with cardiovascular diseases will bring better care, longer and healthier lives and better patient experience – which we must all strive to deliver.'

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