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.
Happy Christmas! 😊 Thank you.
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!
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. 
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
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.
Hmm, looks as though I still have the wrong kind of heart disease, which my GP is unable to monitor or support me with!
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?
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.
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!
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...
Thanks for sharing this. I wonder why thyroid is not on the most recent listing.
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.
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.
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.
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.
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.
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.)
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.
Outrageous reply from MP/Government Minister. This is a bit long, but worth reading as a classic example of political buck-passing!
Advice re High Bilirubin (Gilbert’s) and ‘Borderline’ Iron LevelsThyroid Disease in Ageing Populations
After Some Super Advice on This Forum
Covid 19 and Guidance for Hashimoto’s patients 
