NICE publishes new asthma and COPD indicators

NICE has published new indicators for asthma and COPD, part of a suite of new indicators, which will inform negotiations for the 2020/21 QOF in England.

A review of the current QOF indicators for asthma and COPD was agreed following NHS England’s 2018 review of the QOF.

PCRS representatives have been at the table in discussions about these indicators and fed into consultation process.

Four new indicators will help improve diagnosis and ongoing care for people with asthma. They encourage general practice staff to undertake an annual review that includes an assessment of asthma control using a validated asthma control questionnaire (including assessment of short-acting beta agonist use), a recording of the number of exacerbations and a written personalised action plan.

Assessing the use of short-acting beta agonists and recording exacerbations can help identify people with asthma who are at increased risk of poor outcomes. People with asthma can use information and advice from these reviews to inform how they self-manage their condition, maximising their future health.

The new COPD indicators also recognise the importance of using objective testing to confirm a diagnosis of COPD. They link diagnosis and objective testing to entry on to the QOF COPD register. NICE says this should contribute towards a reduction in both misdiagnosis and the risk of overtreatment in people with COPD.

The work over the last five years to develop indicators for the National Asthma and COPD Audit (NACAP) informed the development of these new indicators.  Katherine Hickman, PCRS Vice Chair Elect, is the primary care lead for this RCP programme. 

PCRS Executive Chair, Noel Baxter, who has also led parts of the NACAP programme, says:  “Respiratory interested clinicians and commissioners interested in Quality Improvement could consider using this list of respiratory indicators for their own local schemes even if they don’t end up in QOF.”