NICE, the health and social care guidance body, has published its latest set of proposals to improve the quality of care provided by family doctors. The indicators have been developed for the 2015/16 Quality and Outcomes Framework (QOF). The decision on which of these indicators will be included in the 2015/16 QOF will be agreed through discussions over the coming months.

This final[1] “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 2015/16 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 2015.

The additions to the NICE QOF menu include: new indicators to support high quality care for people with newly diagnosed hypertension, a new diabetes care processes indicator designed to support holistic and comprehensive care for people with diabetes and a new indicator to help ensure that women with a severe mental illness are given information and advice about pregnancy, conception or contraception. In addition to new indicators, a number of existing QOF indicators have also been revised to reflect updated NICE guidance, this includes guidance on the management of atrial fibrillation and chronic kidney disease.

NICE has updated the atrial fibrillation QOF indicators to reflect updated NICE guidance (CG180). The latest NICE guidance on the management of atrial fibrillation makes a strong recommendation that aspirin should not be offered to people with atrial fibrillation solely for stroke prevention. The updated guidance also recommends the use of a new tool to assess the risk of stroke. To reflect this, two new atrial fibrillation indicators have been added to the NICE QOF menu and one has been taken out.

NICE has also updated two chronic kidney disease QOF indicators; these changes ensure that QOF indicators are aligned with the latest NICE guidance on the early identification and management of chronic kidney disease (CG182).

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 independent QOF 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 Colin Hunter, QOF Advisory Committee Chair, said: “The independent QOF Advisory Committee has thoroughly reviewed evidence-based guidance, consultation responses and feedback from piloting, so we believe that the indicators that we’ve put forward on today’s menu will improve the care that GPs provide for their patients. Our Advisory Committee is made up of healthcare professionals including GPs, and lay members with a wide range of expertise. This depth of experience is invaluable in helping us reach robust clinical decisions on indicators that are practical for GPs to undertake, and that we expect will be essential for improving the quality of patient care.”

Ends

Notes to Editors

About the Quality and Outcomes Framework (QOF)

1. Introduced in 2004, the Quality and Outcomes Framework (QOF) is a voluntary annual incentive scheme that rewards GP practices in the UK for implementing systematic improvements in quality of care for patients. The QOF operates through a points system which rewards GPs for their performance in relation to groups of indicators. NICE’s role is only concerned with the clinical and health improvement indicators.

2. NICE took over the arrangements for managing the new process of developing indicators and reviewing the existing indicators in April 2009. It established a new Quality and Outcomes Framework Indicator Advisory Committee responsible for reviewing existing QOF indicators and recommending new ones before producing a national “menu” of approved indicators which will be made available through the NICE website. 

3. NICE’s QOF indicator menu and supporting information is available on the NICE website: http://www.nice.org.uk/standards-and-indicators.

4. All indicators within the menu are based on the most up-to-date evidence and have been piloted across a range of practices with the support of the University of Birmingham and the York Health Economics Consortium, and the Health and Social Care Information Centre.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Formerly the National Institute for Health and Clinical Excellence, our name changed on 1 April 2013 to reflect our new and additional responsibility to develop guidance and set quality standards for social care, as outlined in the Health and Social Care Act (2012).

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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