UK cost-effectiveness watchdog the National Institute for Health and Clinical Excellence has been awarded new powers by the government to oversee the review the Quality and Outcomes Framework, an annual incentive and reward scheme for GPs.

The QOF – which was first launched as part of the General Medical Services contract back in 2004 - is based on a points system rewarding GP surgeries with cash for their performance in five main groups of indicators, ranging from clinical areas, such as heart disease, to patient experience, such as consultation length.

Following a 13-week consultation with the National Health Service and other stakeholders - which sought the views of clinicians, patient organisations, NHS commissioners and the public - the government has decided that NICE will now oversee the annual review of the clinical indicators included in the QOF from April 2009.

The idea behind the move is that the Institute will utilise its expertise in providing independent clinical advice to review the benefits and cost effectiveness of QOF indicators used to assess the quality of patient care.

“It is important that the scheme continues to provide the best health outcomes and value for money for patients,” said Health Minister Ben Bradshaw. “Asking NICE to lead this new process for prioritising and reviewing indicators will ensure the system is constantly updated to meet changing health needs,” he explained.

Transparent process
Under the government’s plans, NICE is responsible for developing “a more transparent and inclusive process for setting priorities” with input from patients and other stakeholders, and as such will establish an independent Primary Care Quality and Outcomes Framework Indicator Advisory Committee that will assess current indicators as well as recommend new ones.

According to NICE, the Committee will be comprised of “a range of experts and representatives from primary care, including GPs, patients and carers, commissioners and practice and community nurses”, and it has promised that all stakeholders will be given the opportunity to contribute to the development of indicators.

Although Institute will make recommendations on QOF indicators, the final decision on which to be included will still rest with NHS Employers and the British Medical Association.

Alastair Henderson, joint acting director at NHS Employers, has welcomed the move. “We believe that the new process will over time allow Primary Care Trusts more local flexibility in commissioning services, and that it will certainly help to deliver cost and clinical effectiveness,” he said.