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Will bundled QOF diabetes targets for GPs improve or worsen health checks

The NHS will impose strict incentives in an attempt to improve the number of patients with diabetes that receive all the health checks they are entitled to on the NHS each year.
GP practices are awarded money to their budget for successfully carrying out the health checks which patients with diabetes should receive each year. The financial incentives, practices receive are known as the Quality and Outcomes Framework or QOF for short.
To date, practices have received money for individual tests they carry out but results to date show that the numbers of patients receiving all the required tests are too low.
Under the bundled schemen, practices will need to ensure all of the following health checks are carried out in order to receive payments for the tests:

HbA1c test
Cholesterol test
Blood pressure reading
Albumin to creatinine ratio (a measure of kidney health)
Serum creatinine measurement (another kidney health check)
Foot examination
BMI measurement (height and weight)
Smoking status recorded

In response to the bundling plan, some GPs have questioned whether the NHS’s bundle scheme may have the opposite effect to what is intended, essentially incentivising GPs to consider following an all or nothing approach.
There are question marks as to whether GPs will ensure that significant numbers of their diabetic patients receive all the checks whilst ‘giving up’ on a greater quantity of tests for other patients with diabetes. Other points raised by GPs include
The move towards bundling, which is expected to be published in August 2014, could however see a move to get more of the health checks carried out within a single visit, which would be an efficient approach for patients and GPs.

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