News – March 2006

Some of the indicators in the original 10 clinical areas of the QOF have been amended. For example, new indicators have been added to mental health and the indicators for LVD have been replaced by indicators for heart failure. The smoking indicators distributed throughout several clinical areas in the original QOF have been collated together as a new smoking indicator set.

Suffolk GP Dr Matthew Lockyer, who is also a hospital practitioner in diabetic medicine, welcomed the addition of the depression indicators. He said: "Depression is common in chronic disease and may be a major barrier to successful treatment. Some psychological interventions are now becoming an accepted part of the management of new onset diabetes."

For summary tables of the clinical indicators for QOF2, including a breakdown of the points and payment stages, click here.

For an average practice the value of a QOF point will remain £124.60 for 2006/2007 the same as in 2005/2006.

In the first article of our new series on implementing QOF2, Dr Alan Begg gives practical evidence-based advice on tackling the indicators for atrial fibrillation.

SIGN guideline will improve diagnosis of dementia

Taking a detailed history is a key component in the assessment of a patient with suspected dementia, according to the recently updated guideline from SIGN.

As well as recording mode of onset, course of progression and pattern of cognitive impairment the presence of non-cognitive symptoms such as behavioural disturbance, hallucinations and delusions should also be noted.

Complaints about memory loss should be taken seriously, especially in well educated patients, the guideline says.

Subjective memory complaints may be predictive of dementia but may also be associated with depression and anxiety. The guideline recommends screening for comorbid depression as part of the assessment for suspected dementia.

The evidence-based guideline emphasises the importance of identifying the type of dementia so that patients can receive appropriate treatment. It contains annexes listing the diagnostic criteria for Alzheimer's disease, vascular dementia and other subtypes of dementia.

"Early identification of a potentially devastating disease such as dementia is important as this ensures that people receive clinically effective treatment at a point where both they and their carers will be able to appreciate the benefits," said consultant old age psychiatrist Dr Peter Connelly, chair of the guideline development group.

"Our recommendations update existing guidance to clinicians and emphasise the need to improve their recognition of this increasingly common illness," he added.

Copies of SIGN 86 Management of patients with dementia, and the quick reference guide, can be downloaded from the SIGN website:www.sign.ac.uk

Guidelines in Practice launches annual Awards

Entry is now open for the 2006 Guidelines in Practice Awards. If you have completed a successful project to implement national guidance in the NHS now is the time to write it up. The closing date for entries is 30 June 2006.

The overall Award, sponsored by the journal, is open to primary or shared care initiatives to implement national evidence-based guidance in any clinical area. Examples of suitable guidance include the NSFs, NICE, SIGN or academic professional body guidance and the indicators in the QOF.

The winning team will receive an Award of £4,000 to carry on their project and the two runners up £1,000 each.

There are also six sponsored categories for projects in the following areas: asthma; cancer; cardiovascular; COPD; diabetes and NICE guidance. The winning team in each sponsored category will receive £3,000.

Last year GP Dr Peter Standing's team from Bury, Lancashire were the overall winners for their high quality project to tackle the hypertension indicators. Their winning entry was published in full in the December issue.

"It was a great honour for our work to be recognised by the Guidelines in Practice Awards. Our practice were surprised and delighted to win the CHD & hypertension category and amazed to win the overall Award as well," commented Dr Standing.

"Most of the £7,000 prize money will be spent on further research and, in particular, introducing the recommendations of the ASCOT study and the NICE hypertension guidelines (due out later this year)," he told Guidelines in Practice.

"I'd recommend getting potential projects into shape now for this year's Awards. You might just be one of the winners," he said.

Beating the Blues

NICE has recommended Beating the Blues, a computerised cognitive behavioural therapy (CCBT) programme, for mild and moderate depression.The technology appraisal on CCBT, published last month, also recommends the use of FearFighter in the management of panic and phobia. It does not, however, recommend the use of OCFighter, previously called BTSteps, in obsessive compulsive disorder. Patients receiving this therapy should be allowed to continue until it is appropriate to stop, the Institute advises.

Copies of NICE TA97 can be downloaded from www.nice.org.uk

News – March 2006

Contents

BMA publishes guidance on updated QOF

SIGN guideline will improve diagnosis of dementia

Guidelines in Practice launches annual Awards

Beating the Blues