Potential new QOF indicators revealed

New indicators for diabetes, epilepsy and Down's syndrome that could be included in the 2010/11 QOF have been announced by NICE along with those suggested for retirement from the framework.

Insulin injection (Photograph: J H Lancy/HML)
Insulin injection (Photograph: J H Lancy/HML)

The new indicators have been included in a menu of potential indicators which the GPC and NHS Employers will negotiate.

NICE has also suggested a set of indictors for retirement. These will also be subject to negotiation between the GPC and NHS Employers. They include measures of HbA1c, blood pressure and cholesterol in diabetes patients.

Full details of NICE recommendations are available here.

New indicators
The two new diabetes indicators focus on the proportion of patients reaching two new blood pressure targets (150/90 and 140/80). NICE has suggested that the current indicator, with a target of 145/85, be retired.

The new epilepsy indicator is for women with epilepsy under the age of 50 who are taking antiepileptic drugs. It focuses on the proportion of these women who have received information and counselling about contraception, conception and pregnancy in the previous 12 months.

The Down's syndrome indicator is for the percentage of patients aged 18 and over who have a record of blood thyroid-stimulating hormone in the previous 15 months, excluding those who are on the thyroid disease register.

The indicators suggested for retirement have been split into those for which there is a low risk associated with removal from the QOF and those for which there is a higher risk. This risk level will need to be considered during negotiations, NICE has said.

The indicators for which NICE said there would be a low risk associated with removal were: CHD 5 (blood pressure in CHD patients), DM 5 (HbA1c in diabetes patients), DM 11 (blood pressure in diabetes patients), DM 16 (cholesterol in diabetes patients) and STROKE 5 (blood pressure in stroke patients).

The indicators for which NICE said there would be a higher risk associated with their retirement were: DM 22 (eGFR or serum creatinine in diabetes patients), MH 4 (serum creatinine and TSH in patients on lithium therapy) and THYROID 2 (thyroid function tests in patients with hypothyroidism).



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