Quality points for diet and smoking advice

Smoking, obesity and alcohol indicators are being considered for the quality framework for 2008/9 as the DoH looks at how ‘health and wellbeing outcomes' can be incorporated into the GMS contract.

Dr David Colin-Thomé, the DoH’s national clinical director for primary care, described the three as ‘enormous areas’.  

However, while he said that their inclusion would be very welcome in the quality framework, he warned that the indicators should be ‘easy to measure and difficult to game’.  

‘We would need to find good indicators. You could do a huge amount in obesity but you would need good evidence,’ he said.  

He was not sure which indicators would work but said that exercise and lifestyle indicators would be considered.  

GPC deputy chairman Dr Laurence Buckman said that it was unlikely that there would ever be any evidence to show that primary care interventions made a difference in obesity, and although interventions could help alcoholism, he had not seen enough yet to convince him it would be a useful addition.  

He said that the GPC would be happy to work on enhanced services in the areas as long as funding was available.  

The government’s plans for the framework came as part of an update this week on January’s primary care White Paper.  

The report, ‘Making it Happen’, gives details on progress and maps out areas that will change.  

It has set out a timetable to stop ‘open but full’ lists so that patients will be able to join any open list by April 2007.  

It also outlines plans to survey four million GP patients in January about choice and access, and to use practice-based commissioning as a way of making health and social care work more closely.  

Dr Colin-Thomé said that many of the plans in the document would ‘take pressure off GPs’.  

Meanwhile, in a separate briefing at Downing Street this week, prime minister Tony Blair said structural change in the NHS was vital to cut redundant hospital services and move more work into primary care. He said the coming months were ‘critical’ and urged NHS professionals to ‘hold their nerve’.  

Mr Blair admitted there had been some financial mismanagement in the NHS but denied that changes were being made simply to address deficits.

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