Heart failure treatment with beta-blockers, peripheral vascular disease (PVD) and osteoporosis were all put forward for inclusion in the quality framework by the expert review panel, which had worked its way through 153 submissions.
Evidence has shown improved outcomes for heart failure patients given beta-blockers, but the quality framework only pays GPs for prescribing ACE blockers or angiotensin receptor blockers. Another blow to the cardiovascular domains is the omission of PVD.
For the second consecutive year the area has been recommended for inclusion. An estimated 60 per cent of patients with the condition will die from an MI and 12 per cent from stroke.
Dr Sarah Jarvis, west London GP and member of the Target Peripheral Arterial Disease group, said: 'It's completely illogical it wasn't there in the first place.'
The National Osteoporosis Society (NOS) said without osteoporosis in the framework, the care of 3 million elderly people would be undermined.
In a letter to GP, NOS chairman Dr Alun Cooper said: 'Including these new clinical indicators for osteoporosis in the framework would have transformed the way fracture care is delivered to patients. Now it appears that these new indicators will be ditched.'
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