NICE backs QOF target for postnatal mental health checks

GP practices should be incentivised through the QOF to assess the mental health of all women who have recently given birth, according to new indicators proposed by NICE.

All new mothers should receive a ‘comprehensive mental health assessment’ during their routine six-week postnatal appointment, and practices should be incentivised to do this through the QOF, NICE has suggested.

An indicator that would pay practices based on what proportion of postnatal women are assessed using the Whooley 2 depression questions and the GAD-2 scale forms one of 11 indicators put forward by NICE in its draft QOF menu.

The recommendation comes in light of fears that some women were being ‘left unsupported’ during a time they are at increased risk of experiencing depression, anxiety and other mental health problems.

NICE is responsible for developing new QOF indicators, which will be subject to a consultation and trials before being officially recommended for inclusion in the QOF.

It has pressed ahead with its plans to develop new indicators, despite confirmation that the QOF will be frozen with no new indicators added in the 2017/18 contract.

NICE QOF menu

A working group has also been established to consider what future the scheme has from 2018 onwards.

The menu also includes indicators incentivising the creation of a register for all patients on the autistic spectrum and for referring patients newly diagnosed with non-diabetic hyperglycaemia onto the NHS Diabetes Prevention Programme.

Dr Andrew Black, GP at Mortimer medical practice and deputy chair of the NICE indicator advisory committee said: ‘GPs play a vital role in helping vulnerable people to get the correct diagnosis and the support they need.

‘These indicators, put forward by NICE, could help GPs to identify and support their patients who are most at risk. This can only be a good thing.’

Professor Daniel Keenan, chair of the NICE indicator advisory committee, said: ‘Indicators are a key part of NICE’s drive to improve people’s lives, enhance the quality of care in the NHS and use its resources wisely.

‘The indicators in this consultation are not final. And I would strongly encourage everyone with an interest in the development of evidence-based indicators to tell us their views. Your feedback will help us finalise the NICE indicator menu in August.’

Proposed indicators

  • GP1: The practice establishes and maintains a register of all people aged 18 years and over with an episode of AKI in the preceding 12 months.
  • GP2: The percentage of people with an episode of AKI in the preceding 12 months who have had a serum creatinine, eGFR and either an ACR or PCR recorded within 3 months of the record of diagnosis.
  • GP3: The percentage of people aged 18 years and over with an episode of AKI in the preceding 12 months who have had a medication review within 1 month of the record of diagnosis
  • GP4: The percentage of people with an episode of AKI in the preceding 12 months who have been given written information about AKI within 1 month of the record of diagnosis.
  • GP5: The practice establishes and maintains a register of all people on the autistic spectrum.
  • GP6: The proportion of women eligible for screening and aged 25 – 49 years at end of period reported whose notes record that an adequate cervical screening test has been performed in the previous 3.5 years
  • GP7: The proportion of women eligible for screening and aged 50 – 64 years at end of period reported whose notes record that an adequate cervical screening test has been performed in the last 5.5 years
  • GP8: The practice establishes and maintains a register of all people with a diagnosis of non-diabetic hyperglycaemia.
  • GP9: The percentage of people newly diagnosed with non-diabetic hyperglycaemia in the preceding 12 months who have been referred to a Healthier You: NHS Diabetes Prevention Programme for intensive lifestyle advice
  • GP10: The percentage of people with non-diabetic hyperglycaemia who have had an HbA1c or FPG test in the preceding 12 months.
  • GP11: The percentage of women who have given birth in the preceding 12 months who have had an enquiry about their mental health using the Whooley 2 depression questions and the GAD-2 between 4-10 weeks postpartum

Photo: iStock

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