Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to page 15 of the NHS Long Term Plan, published in January 2019, whether the revised GP Quality Outcomes Framework (QOF) proposed in that plan will effect QOF indicators for dementia including (a) new diagnoses, (b) care plans or memory assessment reviews and (c) named carers on records.

Major reform to the GP contract was announced at the NHS England Board meeting on 31 January 2019, which sets out significant investment in general practice, including a focus upon improving care to some of the most vulnerable patients through a multidisciplinary approach. Further information is available at the following link:

https://www.england.nhs.uk/gp/gpfv/investment/gp-contract/

It also included changes to the Quality Outcomes Framework (QOF), reflecting the recommendations of the QOF Review published by NHS England in July 2018 is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/07/quality-outcome-framework-report-of-the-review.pdf

Key changes to the QOF include:

- The retirement of 28 indicators which are either no longer in line with National Institute for Health and Care Excellence guidance, suffer from known measurement problems (usually because of small numbers at a practice level) or represent core general practice activities (175 points);

- The introduction of 15 new indicators in relation to blood pressure management, diabetes, cervical screening, chronic obstructive pulmonary disease and mental health (101 points). These should lead to improvements in patient care and ultimately outcomes;

- The replacement of exception reporting with a personalised care adjustment which recognises the necessity for practices to be able to tailor care to individual patients; and

- The introduction of a quality improvement domain worth 74 points in 2019/20 and, in the first year, focused upon prescribing safety and end of life care.

A number of further reviews of the QOF domains are planned, including that for mental health. In relation to dementia specifically, the current indicator DEM005 (pre-diagnosis blood tests) will be retired due to the small numbers at practice level. This decision is in line with the recommendations of the QOF review. There are no changes to the other two dementia care indicators which focus upon identification and care planning.