The National Institute for Health and Clinical Excellence has unveiled the first list of potential new indicators it is putting forward for the Quality and Outcomes Framework, an annual incentive and reward scheme for GPs.

The QOF was introduced in 2004 as part of the General Medical Services contract with the idea that offering GPs cash if they hit targets in certain areas will help to boost the quality of primary care services. The scheme is based on a points system for performance in five main groups of indicators, ranging from clinical areas, such as heart disease, to patient experience, such as consultation length, and the higher the scores the higher the financial reward for practices.

Earlier this year, NICE was handed the power to oversee the review of clinical and health improvement elements of the QOF, after ex health minister Lord Ara Darzi stressed the need for a more independent and transparent process for choosing indicators in his Next Stage Review of the National Health Service.

Under its new powers, the Institute is expected to use its expertise in providing independent clinical advice to assess the benefits and cost effectiveness of QOF indicators regarding the quality of patient care, to ensure that the scheme provides the best health outcomes and value for money.

New menu
NICE’s menu of potential new indicators includes: epilepsy - the percentage of female patients under 50 who are taking antiepileptic drugs who have a record of information and counselling about contraception, conception and pregnancy; diabetes - the percentage of patients whose blood pressure is under 150/90 and 140/80; and Down’s Syndrome - the proportion of patients on the Learning Disabilities register aged 18 and over who have a record of blood thyroid stimulating hormone in the previous 15 months.

But all eyes will now be on negotiations between NHS Employers and the British Medical Association, which will ultimately decide which indicators make it into the QOF next year and which will be “retired”.