NICE role in QOF 'a step backward' LMCs warn

Proposals to introduce local quality indicators and involve NICE in assessing the quality framework (QOF) have been strongly opposed by LMCs.

North and South Essex LMCs said their members were 'totally opposed' to involving NICE in development of the quality framework.

In response to the DoH consultation on the framework, the LMCs argued that the change would 'hasten DoH control and prevent the framework from being both independent and evidence-based'.

The LMCs also questioned the need to review a system which had been 'instrumental in improving the quality of care of patients and was internationally recognised'.

In its response, Bromley LMC in Kent questioned how changing the way indicators were selected would improve the QOF.

'It seems strange to introduce a "new, independent, transparent and objective process" without piloting this change,' it said. 'Where is the evidence that this new process would be any better?'

The LMC also argued that local indicators would be 'both unnecessary and unfair'. 'Local variations in quality indicators will inevitably lead to a postcode lottery for QOF-sponsored care,' it said.

'PCTs that want to incentivise practices for local priorities are already able to do this through local enhanced services.

'If national QOF money is dedicated to this purpose, GPs in different PCTs will face different obstacles in trying to earn it and, if local money is required, underfunded PCTs will do their very best to ensure it is not spent.'

The NHS Alliance argued that local indicators should make up less than a fifth of those available in the QOF in its response to the DoH consultation.

It also said that GPs and others working in primary care should have more input into NICE's assessment. 'To date there has been insufficient input from general practice and primary care,' it said.

The NHS Alliance has called for GPs to be more involved in all NICE activities, not simply the QOF. The consultation closed this week.

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