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GPs react to proposed QOF indicators targeting non-diabetic hyperglycaemia

Representatives from the Primary Care Diabetes Society (PCDS) have praised the focus on targeting non-diabetic hyperglycaemia in the proposal for new Quality Outcomes Framework (QOF) indicators; however, they have raised concerns that some practices with poor access to the national Diabetes Prevention Programme may be at a disadvantage.

The proposal, which is out for consultation now, presents three indicators related to the Healthier You: NHS Diabetes Prevention Programme, including:

  • The practice establishes and maintains a register of all people with a diagnosis of non-diabetic hyperglycaemia.
  • The percentage of people newly diagnosed with non-diabetic hyperglycaemia in the preceding 12 months who have been referred to a Healthier You: NHS Diabetes Prevention Programme for intensive lifestyle advice.
  • The percentage of people with non-diabetic hyperglycaemia who have had an HbA1c or fasting plasma glucose test in the preceding 12 months.

Speaking to the BMJ, Stephen Lawrence, Principal Clinical Teaching Fellow at the University of Warwick and a Committee member of the PCDS, noted that the Diabetes Prevention Programme is currently available in only half of the country, with full roll-out not expected until 2020.

Clare Hambling, also a Committee member of the PCDS, said that her practice, in Norfolk, provided a range of lifestyle advice directly to patients with non-diabetic hyperglycaemia but would still lose out financially under the new indicators because it did not yet have access to the national scheme. She said: “It’s important that we are trying to offer prevention where we can, but I can’t see how you can include an indicator for something which doesn’t exist in large swathes of the country. Where it doesn’t exist, [the indicator] needs much more flexibility.”

The consultation can be read in full here.

It is open until 8 March 2017, and GPs and interested parties are invited to respond if they foresee any barriers or potential unintended consequences in implementing the proposals.

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