Asthma phone reviews won’t count for QOF

Telephone reviews for patients with asthma cannot count towards Quality and Outcome Framework targets, national arbitrators have ruled.

The national Implementation Coordination Group (ICG) for the nGMS contract has decided that reviews must be conducted face-to-face following a dispute after two primary care trusts disallowed telephone claims.

The ruling has been described as a "retrograde step" by GPs with a special interest in asthma who claims the result will be that more people with uncontrolled asthma will fail to be identified and offered treatment.

The ICG, which includes representatives from the BMA’s GP committee, NHS Employers and the Department of Health, considered the evidence from the Quality and Outcomes Framework (QOF) group.

The ICG finding says: “The QOF group concluded the current evidence base is insufficient to support widespread use of telephone reviews in general practice. The ICG has upheld the recommendation of the QOF group."

PCTs had argued that, since inhaler technique could only be checked in person, it was unsuitable to carry out asthma reviews over the telephone.

However Dr Kevin Gruffyyd Jones, a GP in Wiltshire and chair of the General Practice Airways Group education committee, said telephone reviews could be used to identify patients who were not well controlled who could then be brought into the surgery for their inhaler technique to be checked. Research he has carried out found that telephone reviews allowed his practice to see 35% more patients at 37% less cost.

He told EHI Primary Care: "Their argument was that the research had been done in asthma-interested practices and could not be generalised to all practices but I think that premise is wrong."

Dr Gruffydd Jones said telephone reviews allowed practices to reach patients who would not attend when called for review at the surgery, particularly those 20% or 30% of patients who were above the top threshold for the QOF payment.

He added: "Many of these people will be experiencing frequent exacerbations and by not allowing telephone reviews we will be missing out on the people who need to be seen while wasting our time on people who don’t need to be seen because they are well controlled."

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Asthma reviews by phone don’t count for QoF, say PCTs