NICE may force U-turn on changes to QOF

Ministers are set to face pressure from NICE to reverse controversial QOF changes, after the institute vowed to look at restoring an 'important' target lost in the 2013/14 GMS contract overhaul.

NICE: medicines reviews for patients with polypharmacy 'good practice'
NICE: medicines reviews for patients with polypharmacy 'good practice'

NICE advisers said offering medication reviews to patients with polypharmacy was good clinical care and should be paid for through the QOF.

A target for this was scrapped in England, along with the majority of the organisational domain, in the sweeping GMS contract changes for 2013/14. It was retained in Scotland, Wales and Northern Ireland.

GP leaders said the move showed the government had 'blindly' imposed QOF changes 'without due thought and consideration'.

The target, Medicines 11, paid the average practice about £1,000 to review patients taking four or more drugs. NICE guidance encourages such checks to improve adherence and reduce harm.

At a meeting in Manchester earlier this month, a committee of NICE advisers on the QOF agreed to develop an indicator to restore this requirement, and the payment, to the contract.

Committee chairman Dr Colin Hunter, a GP in Aberdeen, said the target was 'a worthy and important area' of care to consider reintroducing. The new indicator is likely to target high-risk groups first.

GPC negotiator Dr Chaand Nagpaul said NICE had never recommended that Medicines 11 and many other targets should be scrapped. 'The big problem is the QOF changes were unilaterally imposed without due thought and consideration.

'The government didn't consider the consequences of implementing a whole tranche of changes in one year.'

He said the government had 'misused' NICE's advice: 'The changes to QOF have been the making of the government itself.'

NICE will now run a consultation and pilots lasting several months. If approved, the indicator would be unlikely to re-enter the QOF before 2015/16.

Asked whether NHS England would consider reversing the QOF changes in the next GP contract, a spokeswoman said: 'Any change to the GMS contract is subject to negotiation with the GPC in the usual way.'

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