OA rejected for quality framework in 2008/9

Osteoarthritis (OA) has been rejected as a potential quality framework indicator for 2008/9, according to the Primary Care Rheumatology Society (PCRS).

Dr Adam Bajkowski, chairman of the PCRS and a GP in Wigan, told GP he received a letter rejecting the PCRS submission last month.

Professor Helen Lester, who heads the quality framework review team, wrote to Dr Bajkowski saying that it was decided that ‘other areas within primary care were of a higher priority within the context of the quality framework either in terms of prevalence, morbidity/mortality, responsibility for delivery within primary care or practical implementation within primary care computer systems’.

More than 150 submissions have been made to the quality framework review board this year, she added. Those who put forward proposals that are still being considered are being invited to give oral evidence to the  board in a second round of the review process.

The PCRS had wanted annual reviews of patients with osteoarthritis of the knee and hip to be included in the framework.

GPs could have been awarded points for recording BMI, helping weight loss, exercise referrals and, for patients taking NSAIDs, BP and renal checks.

These interventions would help prevent ‘wear and tear’ damage, thereby reducing costs associated with joint replacement, according to the PCRS.

Dr Bajkowski said: ‘We are disappointed it has not gone in and there are a lot of arthritis patients who will be disappointed.’

But he was later told that the rejection was for none of the reasons outlined in the letter.

‘The people involved said it hasn’t been rejected, but regarding prioritisation, it’s not what the DoH wants,’ he claimed.

It is the second time the PCRS has put forward a submission for OA to be included in the quality framework. Dr Bajkowski thought there might be a limit on how much musculoskeletal work can be put in the framework. The National Osteoporosis Society confirmed it is through to the next round and will supply oral evidence in June.

‘I am sure there are more than just clinical issues at stake here in the framework,’ he added.

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