GPs focus on 2008 quality change

GPs are disappointed the quality framework is unlikely to change in 2007/8, but specialist groups are now planning proposals for the next round of negotiations.

Last year GPs were warned to expect ‘minimal change' but last week's breakdown in contract talks between the GPC and NHS Employer meant any alteration from April was unlikely.

The joint quality framework review team is now collecting evidence for 2008. It can expect to hear calls for annual health checks for the obese, STI tests and assessment of patients with dyspepsia to be included.

GP experts were disappointed by the delay. Clinical director of the National Obesity Forum Dr David Haslam, said: ‘A wasted year is a wasted year.'

He added that GPs should be given points for recognising childhood obesity and screening obese adults for BP, blood glucose and cholesterol. Up to 35 points can be earned by offering smoking cessation advice, and a similar incentive should be given for weight-loss recommendations, he said.

Dr Colin Kenny, chairman of the Primary Care Diabetes Society, was also ‘disappointed'.

‘Given that the quality framework was such a success, the obvious thing would have been to tighten and improve it,' he said.

One example of this would be to set tougher BP and cholesterol targets for the growing number of diabetes patients.

Dr Richard Stevens, chairman of the Primary Care Gastroenterology Society (PCGS), said: ‘The quality framework has been very effective in changing GP behaviour.'

He pointed out, however, that it had also resulted in a ‘diversion of time, energy and resources' away from GI tract problems, as they are not in the current quality framework. The PCGS will propose that irritable bowel disease, coeliac disease and acid reflux problems are included. An annual review of patients with dyspepsia would be in line with guidance issued by NICE.

Dr Steve Holmes, chairman of the General Practice in Airways Group, wants the recognition of allergy to be added too.

Dr Chris Ford, chairwoman of Substance Misuse Management in General Practice, said the framework should give points for registering alcohol abuse in related conditions such as diabetes and obesity. STI checks could also be included.


  • Annual screening of BP, HbA1c and cholesterol levels in obese patients.
  • Weight-loss advice.
  • Annual review of patients with dyspepsia.Diagnosis and management of allergy.
  • Alcohol abuse as an indicator.
  • Sexual health emphasis including points for chlamydia screening.



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