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NICE adds nine new indicators to QOF menu

NICE has updated its QOF indicator list for 2019/20, including new indicators on frailty in diabetes.

NICE confirmed that updated indicators on type 2 diabetes will be in place for 2019/20 – two indicators on blood glucose targets for patients with and without frailty, and another setting one blood pressure target for all patients without frailty.

There are three new indicators that have been added since the draft was sent for consultation, including one for patients with type 2 diabetes and a QRISK2 score of 10% or greater treated with a statin, and another for patients with type 2 diabetes over 40 with a statin prescription.

NICE have also addressed concerns over patients with an ‘AF resolved’ code, after research found that these patients are still at a greater risk of stroke than those without AF. The updated indicator for a register of AF patients now includes those with an ‘AF resolved’ code.

NICE deputy chief executive Professor Gillian Leng said that the new diabetes indicators will enable 'greater personalisation of care'.

She said: 'A number of the new NICE indicators for people with diabetes take account of frailty and are a step towards helping enable the greater personalisation of care. The intent of these indicators is to reduce the risk of treatment-related harm and improve the quality of life for people with moderate or severe frailty.'

The indicators in full

NM157 - The percentage of patients with diabetes without moderate or severe frailty, on the register, in whom the last IFCC-HbA1c is 58mmol/mol or less in the preceding 12 months.

NM158 - The percentage of patients with diabetes with moderate or severe frailty, on the register, in whom the last IFCC-HbA1c is 75mmol/mol or less in the preceding 12 months.

NM159 - The percentage of patients with diabetes without moderate or severe frailty, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80mmHg or less.

NM142 - The percentage of patients with type 1 diabetes who are aged over 40 years currently treated with a statin

NM160 - The percentage of patients aged 25-84 years, with a diagnosis of type 2 diabetes, without moderate or severe frailty, not currently treated with a statin, who have had a consultation for a cardiovascular risk assessment using a risk assessment tool agreed with the NHS Commissioning Board in the last three years.

NM161 - The percentage of patients with a diagnosis of type 2 diabetes and a recorded CVD risk assessment score of ≥10% (without moderate or severe frailty), who are currently treated with a statin (unless there is a contraindication or statin therapy is declined).

NM162 - The percentage of patients with diabetes aged 40 years and over, with no history of CVD and without moderate or severe frailty, who are currently treated with a statin (excluding patients with type 2 diabetes and a CVD risk score of

NM163 - The percentage of patients with diabetes and a history of CVD (excluding haemorrhagic stroke) who are currently treated with a statin.

NM164 - The contractor establishes and maintains a register of patients with atrial fibrillation, including patients with ‘AF resolved’.