NICE to consider multimorbidity QOF indicators

QOF indicators for managing multiple long-term conditions will be considered by NICE advisors in June and could be introduced in April 2016.

BP checks: NICE will consider whether to develop QOF indicators for multimorbidity (photo: Jim Varney)
BP checks: NICE will consider whether to develop QOF indicators for multimorbidity (photo: Jim Varney)

NICE advisors will consider at a meeting next month whether to develop QOF indicators for managing multiple long-term conditions. Any new indicators developed as a result could be added to the 'menu' of options for negotiations on the 2016/17 GMS contract.

The proposed new topic is one of four to be considered by NICE's independent Primary Care QOF Indicator Advisory Committee at the meeting.

It marks the first time that NICE has considered a single incentive for managing several chronic conditions, although indicators combining multiple processes within diabetes care have already been proposed and could feature in next year's QOF.

The committee will also consider the development of indicators on improving parity of esteem between mental and physical health, on 'integrated care', and 'outcomes', the meeting agenda shows.

Any indicators subsequently developed would likely be piloted in general practices across the UK, with the results put to the committee for its approval at a future date.

Pilot results due

At the meeting, NICE's advisors will also consider consultation, development and cost effectiveness results on potential QOF indicators that have already been piloted. These include indicators for:

  • COPD self-management

  • Diabetes care processes

  • Hypertension and alcohol

  • Hypertension and target organ damage

  • Polypharmacy

  • Serious mental illness

The agenda shows that the committee will also discuss possible changes to existing QOF indicators, including for cardiovascular disease, smoking, and dual antiplatelet therapy for cardiovascular disease. It suggests experts will debate the age range for the obesity indicator, which currently begins at age 16, and whether to adjust the age range and frequency in the indicator for cervical screening tests (CS002).

The upcoming QOF advisory meeting is the first since the framework was significantly downsized in the 2014/15 contract deal. Health secretary Jeremy Hunt has since declared he would scrap all QOF indicators if he could.

Public Health England has called for QOF to monitor uptake of NICE guidelines in place of the individual targets used at present.

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