In a move that signals a split in a UK-wide GMS contract, Northern Ireland has decided to fund identification and care of peripheral arterial disease (PAD) in general practice.
Northern Ireland GPC chairman Dr Brian Dunn told GP that PAD has been confirmed as one of the new clinical directed enhanced services (DESs) for Northern Ireland, backed by a total of £2.7 million in funding.
'PAD has been included as it is an important marker for coronary heart disease, so having a DES for this could help to reduce the rate of heart disease,' said Dr Dunn.
However, PAD sufferers in England will continue to miss out after the disease was first rejected for inclusion into the quality framework for 2008/9 and then overlooked as one of five new clinical DES agreed to share funding of £50 million by the DoH.
It has been proposed by the Department of Health, Social Services and Public Safety in Northern Ireland that GPs should take a register of PAD patients, carry out secondary prevention and promote smoking cessation in PAD patients over 50 years old.
Dr Sarah Jarvis, west London GP and member of the charity Target PAD, said that patients in Northern Ireland would benefit greatly from the DES.
However, she said its omission from the English list of clinical DESs meant care of the disease had become a postcode lottery.
'It is hugely disappointing that PAD was not added to the quality framework, despite being one of the most important indicators, or made a DES in England,' added Dr Jarvis.
As PAD sufferers are often the most needy patients from the lowest socio-economic backgrounds, there is no rationale for England leaving PAD out of the GMS contract, she said.
Clinical DESs in Northern Ireland for osteoporosis and heart failure will also be announced, according to Dr Dunn.
'These are areas that are high up on the agenda for GPs in Northern Ireland so we are pleased that they have also been included,' he said.
'Overall, we are happy with the clinical areas that have been chosen, but it is quite a lot of work for the amount of funding that is being made available.'
A fourth DES for tackling excessive alcohol consumption was currently being debated, added Dr Dunn.
Clinical DESs for Northern Ireland
- PAD: - register of PAD patient
- secondary prevention
- cut smoking in the over-50s.
- Heart failure.
- Excessive alcohol consumption.
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