NICE backs controversial statin threshold for QOF

NICE has suggested 12 potential indicators for inclusion in the QOF from 2016/17, including targets for referrals to psychological treatment, flu vaccinations and cardiovascular disease risk assessments.

Tick: NICE proposes fresh QOF targets
Tick: NICE proposes fresh QOF targets

Five of the new indicators involve use of the QRISK2 cardiac disease risk assessment tool. NICE recently lowered the threshold for statin prescriptions from 20% risk of cardiac disease in the next decade to 10% - a controversial decision that some GPs found ‘of serious concern’.

A QOF indicator to incentivise treatment at the lower threshold is among those under consideration for 2016/17.

The consultation is open until 23 February 2015 and feedback will be discussed by NICE's revamped indicator advisory committee in June 2015. A menu of indicators - which DH and GPC negotiators will decide whether to add to the QOF - will be published in August.

Professor Gillian Leng, health and social care director at NICE, said: ‘This consultation...provides the opportunity for everyone with an interest to contribute to the development of the 2016/17 indicators.

‘We value this input highly and all feedback will help the new indicator advisory committee decide which indicators will be put forward for publication on the NICE menu for the QOF.‘

New indicators:

  • The percentage of patients aged between 25 and 84 years with schizophrenia, bipolar affective disorder and other psychoses who have had a CVD risk assessment performed in the preceding 12 months
  • The percentage of patients with coronary heart disease, stroke or transient ischemic attack, diabetes, hypertension, peripheral arterial disease, heart failure, chronic obstructive pulmonary disease, asthma, osteoarthritis and/ or rheumatoid arthritis who have had a body mass index (BMI) recorded in the preceding 12 months
  • The percentage of patients with coronary heart disease, stroke or transient ischemic attack, diabetes and/or chronic obstructive pulmonary disease who had a flu vaccination between the preceding 1 August and 31 March.
  • The practice can produce a register of patients who are either resident in a care home or who are housebound.
  • The percentage of patients recorded as being resident in a care home or housebound who have had a medication review recorded in the preceding 12 months.
  • The percentage of patients with a new diagnosis of depression in the preceding QOF year whose notes record an offer of referral for psychological treatment within 3 months of the diagnosis.
  • The percentage of patients with a new diagnosis of anxiety in the preceding QOF year whose notes record an offer of referral for psychological treatment within 3 months of the diagnosis.
  • The percentage of patients aged between 25 and 84 years, with a new diagnosis of hypertension recorded between the preceding 1 April and 31 March who have had a face-to-face cardiovascular risk assessment using the QRISK2 risk assessment tool within 3 months of the date of the hypertension diagnosis.
  • The percentage of patients aged between 25 and 84 years, with a new diagnosis of hypertension or diabetes recorded between the preceding 1 April and 31 March who have had a face-to-face cardiovascular risk assessment using the QRISK2 risk assessment tool within 3 months of the date of the diagnosis.
  • The percentage of patients aged between 25 and 84 years, with a new diagnosis of hypertension recorded between the preceding 1 April and 31 March who have a recorded cardiovascular risk assessment score of 10% or greater who are currently treated with statins.
  • The percentage of patients aged between 25 and 84 years, with a new diagnosis of hypertension or diabetes recorded between the preceding 1 April and 31 March who have a recorded cardiovascular risk assessment score of 10% or greater who are currently treated with statins.
  • The contractor establishes and maintains a register of patients with a 10-year risk of CVD of 10% or more.

For full details, see the NICE consultation document.

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