Epilepsy: Drugs

(asked on 20th January 2020) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, for what reasons no points have been allocated to ongoing management for epilepsy medication in the General Medical Services contract Quality and Outcomes Framework.


Answered by
Jo Churchill Portrait
Jo Churchill
Minister of State (Department for Work and Pensions)
This question was answered on 23rd January 2020

Changes to the Quality and Outcomes Framework (QOF)- including allocation of points- are agreed as part of wider amendments to the General Medical Services (GMS) Contract. These changes are negotiated by NHS England and the British Medical Association’s (BMA) General Practitioners Committee England. Guidance on the 2019/20 GMS Contract concerning the QOF was published by the BMA and NHS England in April 2019. This guidance includes an epilepsy indicator which states that ‘the contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy’. QOF points are generally weighted to the estimated workload associated with an indicator. Registers generally incur a lower workload than other indicators and therefore tend to attract a lower points value than other types of indicators.

Care of patients with long term conditions in general practice is described in the essential services element of the contract and funded through the global sum payment. Patients should expect to receive high quality care irrespective of whether or not their condition is included in the QOF. The QOF indicators will continued to be reviewed going forward.

It is a Care Quality Commission regulatory requirement for general practitioners (GPs) to follow the Medicines and Healthcare products Regulatory Agency’s (MHRA) guidance on valproate prescribing. The MHRA advises that ‘Valproate medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place’.

NHS England are also taking broader action to support implementation of the MHRA pregnancy prevention guidelines. In April 2019, they introduced a new Quality Improvement module on prescribing safety into the QOF. As part of this module they expect practices to audit three measures, one of which is that girls and women of childbearing potential currently being prescribed valproate have had an annual specialist medication review and are taking this in compliance with the pregnancy prevention programme as documented by a specialist in the annual risk acknowledgement form. It is the responsibility of every healthcare professional involved in the prescribing and dispensing of valproate medicines to make sure women are aware of the risks and are on the pregnancy prevention programme.

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