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News – August 2011
New QOF indicator menu for 2012/13 is published by NICE
NICE has published summary recommendations from the quality and outcomes framework (QOF) Advisory Committee on indicators for potential inclusion in the 2012/13 QOF.
The proposed QOF menu is based on the most up-to-date evidence and includes new indicators that have been piloted across a sample of practices. The new indicators cover areas, such as:
- assessment of physical activity in people with high blood pressure and provision of a brief intervention
- assessment and preventive treatment of stroke risk in people with atrial fibrillation
- use of the Royal College of Physicians’ three questions during asthma review
- dietary review in patients with diabetes
- treatment of fragility fractures in patients with osteoporosis
- monitoring and treatment of peripheral arterial disease
- offering support and treatment for smokers.
Amendments to current indicator wording have been suggested in the following areas:
- Cardiovascular disease—primary prevention
- Coronary heart disease
- Dementia
- Depression
- Diabetes
- Epilepsy
- Mental health
- Records.
Recommendations on retiring indicators have been made in the following clinical areas:
- Asthma
- Atrial fibrillation
- Cardiovascular disease—primary prevention
- Chronic kidney disease
- Coronary heart disease
- Depression
- Diabetes
- Epilepsy
- Hypertension
- Hypothyroidism
- Smoking
- Stroke.
Selection of the final indicators for inclusion within the QOF will be decided through the negotiation process between NHS Employers, on behalf of the Health Departments and the General Practitioners Committee on behalf of the British Medical Association.
The QOF menu will help to direct resources to where they are needed most and deliver the best outcomes for patients.
NICE releases quality standard on COPD
The new quality standard on chronic obstructive pulmonary disease (COPD) aims to provide a set of clear statements describing high-quality care in the management and treatment of affected people. The standard consists of 13 statements, which cover aspects such as confirming diagnosis, providing patients with an individualised comprehensive management plan, and offering smoking cessation support to smokers with the disease.
The quality standard for COPD complements the recent Government outcomes strategy on respiratory disease (see below).
Outcomes strategy for COPD and asthma published by DH
An outcomes strategy for chronic obstructive pulmonary disease (COPD) and asthma has been published by the Government. The strategy sets out six objectives to transform the care, quality of life, and health outcomes for millions of people with respiratory disease:
- better prevention of COPD
- reducing premature death
- improving quality of life
- improving safe and effective care
- reducing the impact of asthma
- reducing inequalities in access to and quality of services.
NICE publishes guideline on the management of angina
Stable angina is caused by atherosclerotic obstructive coronary artery disease resulting in poor blood flow through the blood vessels of the heart. It occurs during or after physical exertion or emotional stress. Symptoms include pain or a feeling of discomfort or tightness in the chest. It is estimated that almost 2 million people in England currently have or have had angina and around 14% of men and 8% of women between the ages of 65 and 74 years old have been affected by the condition. Angina is the main symptom of myocardial ischaemia and has an appreciable incidence of acute coronary events and mortality.
NICE has released its guideline on the management of stable angina. Clinical Guideline (CG) 126 partially updates Technology Appraisal 73 and recommends what treatment and care the NHS should offer to people with a diagnosis of stable angina, including the use of anti-anginal drugs and surgery. The aim of the guideline is to stop or minimise symptoms and to improve quality of life and long-term morbidity and mortality.
The recommendations include:
- offering optimal drug treatment—one or two anti-anginal drugs as necessary plus drugs for secondary prevention of cardiovascular disease—for the initial management of stable angina
- considering revascularisation for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical care
- ensuring that regular multidisciplinary team meetings are held to discuss management strategies.
The guideline also covers:
- information and support for people with stable angina
- general principles for treating people with stable angina, including:
- preventing and treating episodes of angina.
The recommendations in the guideline are only for those people who already have a diagnosis of stable angina. Clinical Guideline 95 on Chest pain of recent onset, covers the diagnosis of stable angina and should be read in conjunction with CG126.
BAD releases quality standards for dermatology
Skin disease is the second most common disease in adults, with 24% of the population presenting to their GP each year with a skin problem. The British Association of Dermatologists (BAD) has released eight quality standards for dermatology, which are aimed at meeting the needs of service commissioners in the changing NHS. Each standard is accompanied with a set of recommendations, a list of implications for commissioners, and at least one key performance indicator. The standards describe the key elements of best practice that people with skin problems are entitled to expect.
Report on women’s healthcare services published
A report, produced by RCOG, looks at how NHS women’s health services could be configured to provide high-quality, safe, and timely care. The report covers:
- current network models
- key components of an effective network
- changes to current settings
- implementation of a managed women’s health network.
The framework set out in the report should be used by policy makers and commissioners to make the changes necessary to provide a holistic, high-quality, woman-centred service.
News in brief - The British Medical Association has produced a toolkit for GPs on safeguarding vulnerable adults
It emphasises the obligation doctors have to protect vulnerable adults. The toolkit includes examples of good practice and signposts key guidance and relevant legislation.
News in brief - The DH has issued a simple guide to payment by results
It provides an introduction to the payment system under which commissioners pay healthcare providers for each patient seen or treated, taking into account the complexity of the patient’s needs.
News in brief - A diagnostic tool for emerging clinical commissioning groups (CCGs) is available online
This tool has been released to enable CCGs to self assess their capability across six domains, identify developmental needs, and access resources and examples of good practice.
News in brief - A guideline on peritoneal dialysis in the treatment of stage 5 chronic kidney disease has been published by NICE
It recommends that healthcare professionals provide balanced information on dialysis options to patients.
News in brief - NICE has published guidance on the use of thalidomide and bortezomib for multiple myeloma
Technology Appraisal 228 recommends thalidomide if the patient meets the criteria outlined in the guidance. Bortezomib should be used if thalidomide is either contraindicated or not tolerated.
News in brief - NICE was unable to recommend the use of agomelatine for the treatment of major depressive episodes in Technology Appraisal 231
Agomelatine cannot be recommended as no evidence was submitted by the manufacturer or sponsor
News in brief - Bivalirudin is now recommended for the treatment of ST-segment elevation myocardial infarction (STEMI)
Technology Appraisal 230 recommends bivalirudin in combination with aspirin and clopidogrel for people with STEMI undergoing primary percutaneous coronary intervention.
News in brief - Retigabine for the adjunctive treatment of partial onset seizures in epilepsy has now been recommended by NICE
It is recommended in adults with epilepsy who have not had an adequate response from previous treatment with the drugs specified in the guidance.
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Guidelines in Practice, August
2011, Volume 14 (8)
© 2011 MGP
Ltd
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