Quality and Outcomes Framework guidance for 202... - Thyroid UK

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Quality and Outcomes Framework guidance for 2024/25 - NHS England

helvella profile image
helvellaAdministrator
23 Replies

There are often comments about GPs getting paid to prescribe statins and similar claims.

The document linked below is the official information for NHS England only, and for the year 2024-25.

Quality and Outcomes

Framework guidance for

2024/25

1 April 2024

england.nhs.uk/wp-content/u...

Personally, I find it confusing and not at all clear what constitutes compliance with the framework in some cases. Nonetheless, it seems better to post this link than not.

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helvella profile image
helvella
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23 Replies
amala57 profile image
amala57

Happy Christmas! 😊 Thank you.

HandS profile image
HandS

Thank you very much for sharing this, Helvella.

I have a forthcoming GP appt for my adult daughter who has a severe mental illness and I have been trying to establish the primary care responsibilities for monitoring her physical health…….and this sets out exactly what I needed.

So - you sent me the perfect Christmas present🙂

Season’s greetings!

helvella profile image
helvellaAdministrator in reply toHandS

Sorry to hear that it is helpful - if you see what I mean. Even getting basic information can be extremely hard if you don't already know where to look

Hope it goes well. :-)

HandS profile image
HandS in reply tohelvella

Thank you for your kind wishes 🙂

Yes, you are absolutely correct and its’s a problem exacerbated by ‘professionals’, who should know, giving out spurious - sometime dangerous - information.

It also helps enormously to understand what you can/should expect before engaging with a Provider.

Thanks again

BB001 profile image
BB001 in reply toHandS

I don't know if this is relevant, but if you are claiming PIP, the Benefits and Work website and the guides produced are invaluable. If you register for the bi-weekly email, there is a code in it for a 20% discount off a year's membership to bring the price down to £15.96 (from memory). This may well be useful to other thyroid patients.

HandS profile image
HandS in reply toBB001

Thank you ver much, I will have a look🙂. My daughter originally had a lifetime DLA award and has been on PIP since thr change.

AngelRain profile image
AngelRain

Hmm, looks as though I still have the wrong kind of heart disease, which my GP is unable to monitor or support me with!

BB001 profile image
BB001 in reply toAngelRain

How can you have the wrong kind of heart disease?

AngelRain profile image
AngelRain in reply toBB001

Well, that's what I thought, but she was adamant!

BB001 profile image
BB001 in reply toAngelRain

I gather she did not say what the right sort of heart disease was?

WaystarRoyco profile image
WaystarRoyco

That’s really interesting, helvella . Thanks for sharing. No wonder they keep pushing us to take statins if taking them is registered as a “success” for them (if I’m reading it right) and contributes ultimately to how much money a GP practice will be paid by the government. Also I notice in the contents pages that thyroid is not listed as a clinical domain. No or little incentive for treating thyroid patients, perhaps, another contributing factor in our woeful experience?

helvella profile image
helvellaAdministrator in reply toWaystarRoyco

Thyroid was in a previous version from several, even many, years ago.

One aspect which always concerns me is that once a figure has been reached, the incentive disappears.

With modern computer systems, having and maintaining a register is likely intrinsic to the system. Yet they get points! As here:

CHD001. The contractor establishes and maintains a register of patients with coronary heart disease 4 points

Sure, they need to make sure the right patients have indicators set. And they might look at the numbers occasionally - but probably mainly to ensure they are getting the points.

WaystarRoyco profile image
WaystarRoyco in reply tohelvella

Okay. I hadn’t appreciated thyroid had once been included. Interesting it’s no longer there.

I think the whole points thing is deeply worrying. It’s a form of incentivisation that seems to me more akin to sales folks who are pushing product than medics who should be capable of broad, lateral thinking. It’s Skinner’s Behaviourism in action!

helvella profile image
helvellaAdministrator in reply toWaystarRoyco

Looks like it was removed ten years ago - but links from this page are not helpful as they don't go where you might expect.

Compendium - Thyroid diseases

Open data

Publication Date:

31 Mar 2016

Geographic Coverage:

England, Wales

Geographical Granularity:

Country, Regions, ONS Area Classification, Strategic Health Authorities, Local Authorities, County, Primary Care Organisations, Clinical Commissioning Groups, London Authorities

digital.nhs.uk/data-and-inf...

AND

Quality and Outcomes Framework (QOF) - 2013-14

digital.nhs.uk/data-and-inf...

WaystarRoyco profile image
WaystarRoyco in reply tohelvella

Thanks for sharing this. I wonder why thyroid is not on the most recent listing.

FrostyKnickers profile image
FrostyKnickers in reply toWaystarRoyco

People with poorly treated thyroid disease end up with many of those ailments, diabetes, CVD, depression etc. A friend of mine has Hashis and has been on t4 monotherapy for 30 years, she's had strokes, heart episodes, fits and a whole list of other stuff and just had bariatric surgery! They've told her her thyroid disease will be cured by it!!!! She wasn't even massively overweight just 2 or 3 stone. My friend was diagnosed, I spotted her goitre and suggested she see the GP, over 30 years ago, I was diagnosed 10 years ago having had untreated symptoms for 15 yrs previously.

I take T3 only and my weight varies over 3kgs at most, I hover between 9st 10 and 10st 2 and am 5ft 5, I take no other meds because I have no other ailments. I am a year older than my friend at 63.

They have all that info at their fingertips to collate the research and probably save the NHS a fortune and save many lives. Why don't they? I would suggest the drug companies know why.

WaystarRoyco profile image
WaystarRoyco in reply toFrostyKnickers

Sorry to know about your friend. I’m sure she’s not alone. Before I went to a private endo, I spent at least a decade being told my problems (weight gain, anxiety/depression, gut issues) were anything BUT thyroid related. I was offered statins and antidepressants on several occasions. It’s so crazy.

I’m glad to know your T3 only approach is working for you 😀

And, yes, the drug companies have a lot to answer for but so does the government. They are complicit in this mess IMHO.

FrostyKnickers profile image
FrostyKnickers in reply toWaystarRoyco

Hi again A few years ago I had a chat with my MP (she's since retired) she was very sympathetic but though she tried she just didn't get anywhere trying to change things. Her Party wasn't in government but I doubt it would have made a difference if they had been.

My GP if the time wanted to prescribe me NDT but she was threatened with being struck off by the Endo at the hospital. She retired shortly after.

The drug companies train the senior doctors so that they are complicit in their constant search for higher profits. It all seems rather hopeless unless we educate ourselves or go private.

Lora7again profile image
Lora7again in reply toFrostyKnickers

I did the same 5 years ago

healthunlocked.com/thyroidu...

bikebabe profile image
bikebabe

it is interesting that they took the thyroid one out. Don’t know why. I recall my wonderful GP coming round to my house one year at 8pm on eve of QoF deadline to take blood to get the points. I cannot think that was economically worthwhile of his time /effort so he did it for ‘Quality’ reasons and the practice remains one of the best 10% in Britain twenty years later.

dunestar profile image
dunestar

Thanks Helvella. It's the first time I've seen such a document. My first reaction was how time consuming it must be to maintain all the registers. Time which could otherwise be spent on listening to the patient and really thinking about their treatment.

helvella profile image
helvellaAdministrator in reply todunestar

The registers are actually just markers on each patient record. Effectively "Has patient got diabetes?" - or whatever the QOF requirement states.

Actual time should be minuscule once it has been established - more a case of remembering to tick the right boxes.

And a decent computer system could do a lot of the work - e.g. prompt doctor to tick the diabetes box in those who are taking medicines for diabetes. (Leaving it open to not tick the box if they are getting the medicine for another reason.)

MaggieSylvie profile image
MaggieSylvie

I was sick recently, spent a couple of days in hospital, and without finding any stones or discussing my diet, even asking whether I drank, the consultant was adamant that (at 80) I should have my gall bladder removed. I have been horrified at their knee-jerk reaction, and saw through it. Presumably there are advantages to those who perform surgery. And I am not going to be their guinea pig. My GP agrees with me wholeheartedly about a one-off situation. I am grateful that they brought me back to health very quickly, but do not intend to have any unecessary surgery. If it happens again, I will reconsider. So I'm just adding to what you have written about prescriptions; I think you are right, and it goes further than statins. Oh yes, I believe there is a move to put me on those "for my colesterol". "What colesterol?" was my reaction. I don't want any medication that is handed out willy nilly to people above a certain age.

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