The decision on which of these indicators will be included in the 2016/17 QOF will be agreed through discussions over the coming months. The NICE menu for the QOF includes new indicators alongside updates to existing indicators. New indicators have been developed to identify those people with severe mental illness that have a high risk of cardiovascular disease. Other new indicators support access to psychological treatment for people with anxiety and depression. Updates to existing indicators have been made to ensure that the NICE menu for the QOF is aligned with the latest evidence, as set out in NICE guidance.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “These new indicators for general practice will help set high standards of care and improved outcomes for patients.  All of the indicators are based on the best evidence and have been developed in consultation with professional groups, patients and community and voluntary organisations. They have also been tested across general practice to make sure they work. The Indicator Advisory Committee has carefully considered the indicators before recommending them for inclusion in this final menu, and we are confident they will improve patients’ health.”

Dr David Shiers, Retired GP and Carer, North Staffordshire; Clinical Advisor to National Audit of Schizophrenia (2011-2015,) said: “What these new QOF indicators do, is acknowledge a group of people like my daughter, many in their twenties and thirties, at ages primary care would not normally consider for active primary or secondary cardiovascular prevention, who are at high risk of dying young. Living with the day-to-day reality of severe mental illness for over twenty years, I struggle to think how she and we would cope with an ‘extra’ condition like diabetes or heart disease.  Prevention is the key and that's what these new indicators allow."

After the consultation period in January and February 2015 and as part of the process of finalising the indicators, a number of amendments were made to the indicators that the committee recommended for inclusion within the NICE menu for the QOF. Updates to the primary prevention of cardiovascular disease indicators were made to ensure that they reflect the intent of the underpinning NICE guideline for lipid modification (CG181). Piloting and testing will therefore be undertaken to inform further potential general practice indicators covering the following elements of the NICE guideline:

• lifestyle modification
• informed decision making
• statins prescribing for people that have a 10% or greater 10-year CVD risk
• the establishment of a register that would allow the identification of people with a 10% or greater risk 10-year CVD risk

Professor Danny Keenan, Indicator Advisory Committee Chair, said: “The committee and I hope that this latest set of indicators being recommended by NICE for consideration by clinicians, managers and commissioners will prove useful in helping improve the services that we all offer to our patients. In addition we hope that they will help reassure patients that the care they receive is of the highest quality.

“All the indicators have important evidence backing them up. They have been tested out and have received favourable responses from general practitioners.”

Professor Keenan continued: “What is really exciting is that the new indicators cover a wide range of conditions and have moved into the more difficult to manage areas such as mental illness and the physical ill health that goes along with severe mental illness. We have worked on indicators relating to obesity and will be consulting further on the management of cholesterol in general practice.”

We hope that these new indicators will be a useful addition to the suite of indicators already available for use.”

This final ‘menu’ of indicators will help target resources where they are needed most and deliver the best results for patients. NHS England and the devolved administrations of Northern Ireland, Scotland and Wales will use the NICE QOF menu to decide which indicators are included in the 2016/17 QOF within their countries. The decision regarding which indicators should be added to and taken out of the QOF is decided through negotiations.

In England, NHS Employers on behalf of NHS England, and the General Practitioners Committee on behalf of the British Medical Association decide which indicators are included within the QOF. Separate but similar negotiation processes are carried out within Northern Ireland, Scotland and Wales. NICE and the QOF Advisory Committee are not involved in these negotiations. Each country will publish their agreed QOF in April 2016.