National Institute for Health and Clinical Excellence (NICE)
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Indicators to improve dementia care proposed for QOF 2014/15

Three new indicators to improve dementia care could be added to the Quality and Outcomes Framework (QOF) incentive scheme for UK practices, as NICE unveils potential indicators for 2014/15.

There are around 800,000 people with dementia in the UK, and the disease costs the economy £23 billion a year. By 2040, the number of people affected is expected to double due to an ageing population - and the costs are likely to treble.

The Department of Health has made improving care for dementia patients a key priority and the Prime Minister's Dementia Challenge, launched in March 2012, sets out plans to go further and faster in improving dementia care, focusing on raising diagnosis rates and improving the skills and awareness needed to support people with dementia - and their carers.

As part of the final menu of QOF indicators for 2014/15, GPs could be encouraged to record the percentage of patients with dementia who have attended a memory assessment service.

A new dementia indicator will encourage practices to record the name and contact details of the carers of each patient with dementia. This is to help improve communication between practices and other teams, such as out of hours care.

Practices could also be encouraged to measure the percentage of patients with a new diagnosis of dementia, with a record of FBC, calcium, glucose, renal and liver function, thyroid function tests, serum vitamin B12 and folate levels recorded.

Elsewhere, there is a new indicator for recording the percentage of patients whose hypertension is confirmed using ambulatory or home blood pressure monitoring - in line with the updated hypertension guidance from NICE.

NICE has put forward new indicators for blood pressure control in patients with peripheral arterial disease, coronary heart disease, a history of stroke or TIA.

NICE has also recommended a new diabetes and a new epilepsy indicator which will ask GPs to record the percentage of women who have received pregnancy, conception or contraception advice. Women with both types of diabetes and women with epilepsy are at an increased risk of adverse pregnancy outcomes when compared to the general maternity population.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “These proposed new indicators for family doctors will help set high standards of care and improved results for patients.

“All of the proposed new indicators are based on the best evidence and have been developed in consultation withprofessional 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, added: “The independent QOF Committee has thoroughly deliberated on all of the evidence, consultation responses and feedback from piloting, so we believe that the ten proposed indicators that we've put forward on today's menu will improve the care that GPs provide for their patients.

“Our independent Committee is made up of healthcare professionals 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.”

The final decision on which indicators will be added to the QOF will be made by the British Medical Association's General Practitioners Committee and NHS Employers.

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