NICE's new standards cautiously welcomed

NICE's new best practice standards have been cautiously welcomed by leading GPs.

NICE quality standards will have to form the basis of GPs' commissioning decisions, the government has said. The standards will also be used to assess GPs' and other NHS providers' performance and to determine levels of pay.

The White Paper Liberating the NHS said all NHS commissioning would have to be based on NICE quality standards and that pay and inspection would be based on these.

But until last week, just three of the intended 150 standards had been produced.

NICE has now revealed the next nine topics, giving a far clearer view of what the system will look like.

The nine quality standards will cover diabetes (type-1 and type-2), COPD, heart failure, kidney disease, depression, end-of-life care, breast cancer, alcohol dependence and glaucoma. These will complement standards covering stroke, dementia and venous thromboembolism (VTE) prevention which were published last month.

GPC member Dr Bill Beeby said he thought the standards would be useful and that NICE was the right organisation to draw them up. But he warned it was unclear how GP commissioners would manage to meet them when current arrangements had failed to.

RCGP clinical lead for diabetes Dr Brian Karet said that guidance on services for people with type-1 diabetes could be helpful to commissioners.

But he questioned the need for another guideline on commissioning type-2 diabetes services.

'There's loads of stuff already out there,' he said. 'It is ridiculous that we have to have so many guidelines. Do we really need another one? Is anyone going to take any notice of it?'

Many of the topics covered by the new standards overlap with QOF targets, but NICE has said the quality standards will not supersede current indicators.

'Although quality standards may cover clinical and health improvement topics included in QOF, they are intended to supplement, not replace, current QOF indicators,' a NICE spokeswoman said.

The quality standards 'are intended to provide a clear description in around five to 10 statements of what a high quality service would look like', NICE said.

The standards could also 'be used for clinical audit and governance reports as well as in professional development'.

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