Response on behalf of The Carers’ Resource to Consultation on the Proposed Changes to the NICE Quality Outcomes Framework

Last changed: Friday 8 March, 2013

Responding from a carers perspective the proposed changes to the QOF both in terms of the new indicators and the proposals by Government in October 2012 to remove all the organisational indicators (which includes the ONLY dedicated QOF points directly related to carers) is disappointing, unacceptable and discriminatory.

Whilst we appreciate the inclusion of 3 indicators relating specifically to carers of people with Dementia – this is simply insufficient for meeting the needs of carers more generally and could well be seen as discrimination against all carers except those in dementia caring situations.

As fewer than 1 million people in the UK have diagnosed dementia this equates to a maximum of 1 million carers – however as we know there are almost 6 million carers in England and Wales alone if this indicator is the sole means by which GPs are being encouraged/paid to identify, support and refer carers (which it would be if the organisational indicators are removed) then what is to be made of the plight of the other 5 million plus?

If you consider the other additional indicators relating to Stroke, Diabetes and Heart Disease and you calculate the number of people thought to live with/suffer from these conditions each year you reach over 5.5. million – perhaps half of these people will have sufficient difficulties to require support from one or more carers. Therefore why is it not possible to include indicators relating to identifying and supporting carers in each of these indicators also?

Whilst this consultation asks only about the proposed new indicators we feel it is critical that comment is made regarding the Government’s proposal to remove all of the current organisation indicators which include MS9 – the indicator asking GPs to identify carers, hold a register and refer them for support. As GPs will be the powerhouses of health care going forward, commissioners and budget holders surely it is vital that some mention, some indicator somewhere highlights the need for support for carers – tomorrow’s patients if not helped in their own right today.

There is evidence to prove that early identification and appropriate referral by a GP makes carers more likely to accept help and therefore maintain a stable caring situation going forward. If there is no mention at all of carers in either the QOF or COF frameworks then carers will simply disappear off the radar and lose all chance of getting help in their role as carers, waiting until they become patients themselves and situations are at crisis point before intervention becomes possible.