NICE to overhaul QoF

The Quality and Outcomes Framework (QoF) is to be overhauled to focus on indicators which have the greatest impact on health and are proven to be cost-effective, according to Lord Darzi.

The health minister and author of the government’s NHS Next Stage Review told Parliament’s Health Committee that the National Institute for Clinical Effectiveness (NICE) would be given the job of reviewing QoF.

He told MPs: “We need to identify the evidence. We need to look at what are the areas that will make the greatest impact on the health of the nation and weight that evidence base for cost-effectiveness.”

Lord Darzi listened to MPs who argued that osteoporosis-prevention should have been included in the QoF but said this would be weighed alongside all other interventions as the original QoF was reviewed.

“QoF points were never done in the most transparent and evidence-based way,” he added.

Lord Darzi said the recommendations from NICE would be taken up by NHS Employers for negotiation with GP representatives for inclusion in the GP contract.

The Health Committee was taking evidence from Lord Darzi, NHS chief executive David Nicholson and Dr Jonathan Sheffield, medical director for the NHS South West, as part of its inquiry into the NHS Next Stage Review.

Lord Darzi told MPs that patient choice was essential to his proposed reforms but that it had to be “informed choice”.

He added: “Choice is no longer about which hospital you choose to get the quickest treatment now that we have the 18 weeks target. Choice needs to move on.”

Referring to the publication last week of mortality data by NHS Choices he said mortality rates were “one of the crudest, bluntest instruments” for measuring quality.

The MPs also questioned Lord Darzi and Dr Sheffield on GPs ability to refer to a named consultant. Hospitals that use the Choose and Book system to prevent referrals to named consultants have been heavily criticised by GPs but Lord Darzi told MPs that referral to an individual consultant had been replaced by a team approach.

Dr Sheffield said referral to a named consultant was an “old-fashioned model”. He added “It’s impossible for GPs to know the individual special interests of every single consultant so referral to a team is a much better methodology.”