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Grouping diabetes checks could confuse score and reward process By Alistair Kleebauer @alistairbauer Diabetes nurses have questioned whether GP practices will have the staff capacity to carry out eight health checks on diabetes patients recommended by the National Institute for Care and Health Excellence (NICE). NICE has published proposals that would mean GP surgeries would carry out eight annual checks. But Claire MacArthur, a diabetes specialist nurse at South Tees Hospitals NHS Foundation Trust, said staffing problems could mean some GP practices could struggle to complete all eight tests. ‘Well-organised practices will still benefit people with diabetes, but staffing issues in particular – whether shortage, sickness or training – always have an effect on the achievement of indicators in practice,’ she said. Concerns have also been raised that GP surgeries may not perform the complete set of checks if the UK governments decide to only pay the surgeries for completing all eight.
NICE has grouped together eight tests of a patient with diabetes in its Quality and Outcomes Framework (QOF) menu. The QOF is a voluntary scheme for GPs in the UK in which they are scored for level of achievement in different care practices. NHS England and the health administrations in Northern
‘STAFFING ISSUES HAVE AN EFFECT ON THE ACHIEVEMENT OF INDICATORS IN PRACTICE’ Ireland, Scotland and Wales can use NICE’s menu to set their own QOFs. Measurements of blood pressure, body mass index and cholesterol – commonly carried out by practice nurses – are important in ensuring that people with diabetes do not develop complications. In NICE’s proposal they have been grouped with five other measurements to be carried out annually on people with diabetes. The other diabetes measurements are: HbA1c (glycated haemoglobin); smoking status; condition of feet;
albumin to creatinine ratio; and serum creatinine. The National Diabetes Audit 2011/12 showed that less than 10 per cent of people are offered the full series of tests in parts of England. Simon O’Neill, nurse and director of health intelligence at charity Diabetes UK, said putting all eight indicators together may be a ‘better incentive’ for practices to perform all eight. But he added: ‘If you have a patient that refuses to have a blood test done, you won’t get paid for the other measurements. It depends how they score it and reward practices through QOF.’ Practice nurse Linda Drake said: ‘I would expect all practice nurses providing long-term conditions management for people living with diabetes to be already doing all eight checks. What I am interested in is the percentages and targets applied with each check. It is essential in promoting self-management for people with diabetes that their targets are agreed between patient and healthcare provider and they are clinically appropriate.’
Nurses and healthcare assistants pitched ideas to improve care in a Dragons’ Den-style event at Northern Lincolnshire and Goole NHS Foundation Trust last week. Front line staff faced a panel of trust bosses, including chief nurse Karen Dunderdale (pictured), in a session modelled on the hit TV show. The aim was to win a share of £15,000 funding for their projects. The scheme was set up to encourage staff to bring their ideas for improving quality and care to the attention of the board, and has so far attracted two dozen proposals. Among those to appear before the dragons was the trust’s tissue viability team, which secured funding to develop a pressure ulcer grading wheel to help staff classify cases.
GUZELIAN
Staff seek funds in NHS version of Dragons’ Den
NURSING august 13 other :: voluses 28 no 50 ::permission. 2014 11 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 16, 2015. For personal use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
Grouping diabetes checks could confuse score and reward process By Alistair Kleebauer @alistairbauer Diabetes nurses have questioned whether GP practices will have the staff capacity to carry out eight health checks on diabetes patients recommended by the National Institute for Care and Health Excellence (NICE). NICE has published proposals that would mean GP surgeries would carry out eight annual checks. But Claire MacArthur, a diabetes specialist nurse at South Tees Hospitals NHS Foundation Trust, said staffing problems could mean some GP practices could struggle to complete all eight tests. ‘Well-organised practices will still benefit people with diabetes, but staffing issues in particular – whether shortage, sickness or training – always have an effect on the achievement of indicators in practice,’ she said. Concerns have also been raised that GP surgeries may not perform the complete set of checks if the UK governments decide to only pay the surgeries for completing all eight.
NICE has grouped together eight tests of a patient with diabetes in its Quality and Outcomes Framework (QOF) menu. The QOF is a voluntary scheme for GPs in the UK in which they are scored for level of achievement in different care practices. NHS England and the health administrations in Northern
‘STAFFING ISSUES HAVE AN EFFECT ON THE ACHIEVEMENT OF INDICATORS IN PRACTICE’ Ireland, Scotland and Wales can use NICE’s menu to set their own QOFs. Measurements of blood pressure, body mass index and cholesterol – commonly carried out by practice nurses – are important in ensuring that people with diabetes do not develop complications. In NICE’s proposal they have been grouped with five other measurements to be carried out annually on people with diabetes. The other diabetes measurements are: HbA1c (glycated haemoglobin); smoking status; condition of feet;
albumin to creatinine ratio; and serum creatinine. The National Diabetes Audit 2011/12 showed that less than 10 per cent of people are offered the full series of tests in parts of England. Simon O’Neill, nurse and director of health intelligence at charity Diabetes UK, said putting all eight indicators together may be a ‘better incentive’ for practices to perform all eight. But he added: ‘If you have a patient that refuses to have a blood test done, you won’t get paid for the other measurements. It depends how they score it and reward practices through QOF.’ Practice nurse Linda Drake said: ‘I would expect all practice nurses providing long-term conditions management for people living with diabetes to be already doing all eight checks. What I am interested in is the percentages and targets applied with each check. It is essential in promoting self-management for people with diabetes that their targets are agreed between patient and healthcare provider and they are clinically appropriate.’
Nurses and healthcare assistants pitched ideas to improve care in a Dragons’ Den-style event at Northern Lincolnshire and Goole NHS Foundation Trust last week. Front line staff faced a panel of trust bosses, including chief nurse Karen Dunderdale (pictured), in a session modelled on the hit TV show. The aim was to win a share of £15,000 funding for their projects. The scheme was set up to encourage staff to bring their ideas for improving quality and care to the attention of the board, and has so far attracted two dozen proposals. Among those to appear before the dragons was the trust’s tissue viability team, which secured funding to develop a pressure ulcer grading wheel to help staff classify cases.
GUZELIAN
Staff seek funds in NHS version of Dragons’ Den
NURSING august 13 other :: voluses 28 no 50 ::permission. 2014 11 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 16, 2015. For personal use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
