Osteoporosis and Crystal Balls

Waiting, waiting. We are waiting for this years data but just around the corner is also the report from the review group as to what they would like to see in next year's QOF.

Well a rather heavy hint has arrived in the form of Evaluation of standards of care for osteoporosis and falls in primary care commissioned by the Information Centre from the Kings Fund. (it was published co-incidentally with the National Library for Health's Osteoporosis & Fragility Fractures National Knowledge Week which I seem to have missed).

The King's Fund document is a very thorough review of current information in practice systems about osteoporosis (basically not a lot) and the possibilities of generating some useful QOF targets. It seems to be possible. It is however a relentlessly practical document - for which its authors deserve a lot of credit. It is acknowledged that it is very difficult to work out differences in coding from differences in practice. New codes and a proper definition of treatment are required. The huge (and probably undefinable) strain on investigative resources in secondary care are also highlighted. One final conclusion stands out as understanding the problems with QOF.

A preferred set of codes would need to be agreed and disseminated to GPs at least three months before implementation.

You would not normally think that you needed to point out that design needs to come before implementation, but in the wake of last year's mental health mess apparently you do.

Only one problem remains - what goes out for this to come in? No word yet and very little time if it is to be implemented properly next year.

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