National Institute for Health and Clinical Excellence (NICE)
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NICE welcomes confirmation of central role in GP quality incentive scheme

The National Institute for Health and Clinical Excellence (NICE) is to oversee an independent, transparent and objective process for prioritising, developing and reviewing Quality and Outcomes Framework (QOF) indicators for GPs in England from 1 April. Confirmation of NICE’s role comes at the end of a Department of Health (DH) consultation with patients, carers, NHS professionals and commissioners on how the new process should work.

A key part of the new NICE process for QOF is the creation of an independent Primary Care Quality and Outcomes Framework Indicator Advisory Committee that will review existing indicators and recommend new ones. NICE has already received over 60 applications for positions on the Committee.

Commenting on today’s announcement Val Moore, NICE Implementation Director said: “The interest shown in the advisory committee demonstrates the high level of confidence that exists within the primary care sector for our involvement in the QOF. For QOF to continue to be successful it is important that NICE is able to work effectively with primary care stakeholders, a sentiment that was reflected in many of the comments received during the consultation which stressed the importance of primary care stakeholders being fully involved in the process. The Committee, whose membership will be finalised shortly, will include a range of experts and representatives from primary care, including GPs, patients and carers, commissioners and practice and community nurses. NICE will also ensure that all stakeholders have a clear opportunity to contribute to the development of indicators at every stage of the process. This will include enabling interested parties to submit ideas for priority topics via the NICE website, as well as submitting comments on proposed indicators during the consultation phase.”

“The purpose of NICE evidence based guidance is to support professionals in making best use of NHS resources. It is sometimes confusing for professionals when different pieces of national guidance don’t recommend the same things. At worst it undermines the uptake of evidence based best practice. For this reason it is important that new QOF indicators are also under-pinned by evidence of clinical and cost effectiveness. In the future, QOF will not just be restricted to those areas covered by NICE guidance. But whatever QOF does cover, it is important to ensure that the new NICE process for QOF is informed by stakeholders with experience in primary medical care.”

Val Moore, NICE Implementation Director continued: “High quality care depends on decisions made on the basis of the best evidence. Placing NICE at the heart of the process that will ensure that QOF continues to support healthcare professionals in delivering outcomes to patients that are among the best in the world is a strong endorsement of NICE and our considerable expertise and experience gained over 10 years of producing evidence-based clinical and non-clinical guidance.”

An interim process guide giving full details of the open and transparent process NICE will apply to the development and review of QOF indicators will be published shortly. In summary the key steps will be:

• NICE will collate information to inform the prioritisation of new indicators based on evidence of clinical and cost-effectiveness. This will include a facility on the NICE website to allow interested parties to submit potential clinical and public health priority topics.

• The relative priority of these topics for inclusion in QOF would then be considered by the Advisory Committee.

• NICE will then carry out a consultation on the developed indicators before validating the final proposals through the Advisory Committee and publishing its conclusions via the NICE website.

• Each recommended indicator will be accompanied by a suite of supporting information - for example, on when new and renewed indicators should be reviewed and on the cost-effectiveness evidence to inform their financial value.
NICE will make recommendations on QOF indicators, but the decision on which ones are and aren’t included in the framework will continue to be a matter for consultation between NHS Employers, on behalf of the Department of Health, and the British Medical Association (BMA).

For more information call the NICE press office on 0845 003 7782 and out of hours on 07775 583 813.

Notes to editors

About the QOF

1. Introduced in 2004 as part of the General Medical Services Contract, the Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in the UK, rewarding them for how well they care for patients.

2. The QOF operates through a points system which rewards GP surgeries for their performance in relation to five main groups of indicators. These indicators range from those relating to clinical areas such as coronary heart disease, and hypertension, to patient experience such as the length of consultations.

3. NICE’s role will be to review existing indicators and produce potential new ones. This process will be overseen by the Primary Care Quality and Outcomes Framework Indicator Advisory Committee. The decision as to which indicators are incorporated into the final framework will then be decided during discussions between NHS Employers and the British Medical Association (BMA) before being rolled out nationally.

About the QOF Advisory Committee

4. Although the final size of the Primary Care Quality and Outcomes Framework Indicator Advisory Committee is still being confirmed each member will serve for a 3 year term.

5. The first meeting of the Primary Care Quality and Outcomes Framework Indicator Advisory Committee is scheduled for 8 June.

6. Over 60 applications for membership of the Primary Care Quality and Outcomes Framework Indicator Advisory Committee were received before the application deadline for healthcare professionals closed on 6 March. These include applications from 27 GPs, 12 Academics and 8 Public Health professionals. A further 17 applications have also been welcomed from patients and carers who had until 11 March to apply.

7. All four UK countries have provisionally agreed to take part in the NICE-lead process and professionals from the primary care setting within each country will be represented and involved in the new process. This will include representation on the Primary Care QOF Indicator Advisory Committee.

About NICE

8. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

9. NICE produces guidance in three areas of health:
public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS
clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS

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