Sixty Years of Diabetes Management in Primary Care
Sixty Years of Diabetes Management in Primary Care
Although the development of new treatment options and advances in monitoring and delivery equipment were important factors in the evolution of diabetes management (figure 1), there have been some important publications defining best practice for patients with diabetes. The NSF for diabetes in the UK outlined expected standards for diabetes management. These were implemented in April 2003. The new GP contract and the introduction of the Quality Outcomes Framework (QOF) in 2004, incentivised GPs to achieve specific targets for diabetes management. Introduced in 2004 as part of the General Medical Services Contract, the QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients.
The QOF contains groups of indicators, against which practices score points according to their level of achievement. NICE has been asked to focus on the clinical and health improvement indicators in the QOF, which includes a number of domains such as diabetes, coronary heart disease and hypertension.
The QOF gives an indication of the overall achievement of a practice through a points system. Practices aim to deliver high quality care across a range of areas, for which they score points. Put simply, the higher the score, the higher the financial reward for the practice. The final payment is adjusted to take account of the practice list size and prevalence. The results are published annually. NICE's role is to manage the process to develop the clinical and health improvement indicators for the QOF. This involves prioritising areas for new indicator development, developing and selecting indicators, and ensuring consultation with individuals and stakeholder groups. The figures for the Letchworth practice where I was a principal are shown in Table 1.
Health Service Strategies
Although the development of new treatment options and advances in monitoring and delivery equipment were important factors in the evolution of diabetes management (figure 1), there have been some important publications defining best practice for patients with diabetes. The NSF for diabetes in the UK outlined expected standards for diabetes management. These were implemented in April 2003. The new GP contract and the introduction of the Quality Outcomes Framework (QOF) in 2004, incentivised GPs to achieve specific targets for diabetes management. Introduced in 2004 as part of the General Medical Services Contract, the QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients.
The QOF contains groups of indicators, against which practices score points according to their level of achievement. NICE has been asked to focus on the clinical and health improvement indicators in the QOF, which includes a number of domains such as diabetes, coronary heart disease and hypertension.
The QOF gives an indication of the overall achievement of a practice through a points system. Practices aim to deliver high quality care across a range of areas, for which they score points. Put simply, the higher the score, the higher the financial reward for the practice. The final payment is adjusted to take account of the practice list size and prevalence. The results are published annually. NICE's role is to manage the process to develop the clinical and health improvement indicators for the QOF. This involves prioritising areas for new indicator development, developing and selecting indicators, and ensuring consultation with individuals and stakeholder groups. The figures for the Letchworth practice where I was a principal are shown in Table 1.
Source...