Proposals to retire four indicators for CHD, epilepsy and mental health were outlined in recently released minutes from a June committee meeting held largely behind closed doors. These will join seven other indicators already scheduled for removal but postponed due to the swine flu outbreak.
Meanwhile, the committee also recommended that the threshold for HbA1c target should be increased from 7% to 7.5%, after a review concluded it could be harmful to subject patients with long-term diabetes to stringent controls.
It proposed that assessment of asthma control should include the Royal College of Physicians' ‘three questions’. The changes would apply to existing indicator Asthma 6 and will be added to NICE's menu of indicators.
A final decision on the retirement of four indicators will be made by negotiators in the autumn.
These include: cholesterol checks for patients with CHD (CHD7); recording seizure frequency (EP6) and medication review (EP7) for epileptic patients; and following up on patients with mental illness who do not attend their annual review (MH7).
These will join seven other indicators earmarked for retirement in July 2009. Indicator MH7, for patients with mental illness on lithium within the theraputic range, will not now be retired in light of new evidence.
Other recommendations included shortening the time period between treatment reviews for patients on lithium therapy for serious mental illness.
However, the committee could not reach a consensus on the timeframe for reducing the cancer review from six months to three months, and agreed further assessment was needed.
The committee did agree to develop an indicator for structured risk assessment for people with AF, and indicators to incentivise appropriate therapy for those people with AF at differing risk.