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    Indicator development programme

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    Introduction

    This consultation paper includes:

    • Proposed general practice level indicators focussed on the prescribing of strong opioids for chronic pain and on ensuring annual medication reviews for patients on long‑term opioid treatment. Their aim is to reduce harm by identifying prescribing of opioids where it is not recommended and by encouraging timely reviews to manage the risks associated with long-term opioid treatment.

    • Proposed general practice level indicators focused on prescribing of medicines for treatment of type 2 diabetes. The sections on medicines in the NICE guideline on type 2 diabetes in adults have recently been updated to reflect holistic management of type 2 diabetes, and these indicators focus on medicines that show benefit of cardiovascular and renal protection as well as reduction of HbA1c.

    • Proposed general practice level indicators focused on antibiotic use in people with acne. The aim is to support national antimicrobial stewardship (AMS) action plans, ensure optimal antibiotic prescribing and reduce avoidable antibiotic resistance.

    Stakeholders are asked to consider the following questions when commenting on the proposed indicators:

    1. Do you think there are any barriers to implementing the care described by these indicators?

    2. Do you think there are potential unintended consequences to implementing/ using any of these indicators?

    3. Do you think there is potential for differential impact (in respect of age, disability, gender and gender reassignment, pregnancy and maternity, race, religion or belief, and sexual orientation)? If so, please state whether this is adverse or positive and for which group.

    4. If you think any of these indicators may have an adverse impact in different groups in the community, can you suggest how the indicator might be delivered differently to different groups to reduce health inequalities?