Chronic Disease Management Beyond QoF Payments Dr Bruce Davies.
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Chronic Disease Management Beyond QoF Payments Dr Bruce Davies
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Transcript of Chronic Disease Management Beyond QoF Payments Dr Bruce Davies.
Chronic Disease Management
Beyond QoF PaymentsDr Bruce Davies
Scope
What common diseases?Should they be formally managed?
FrequencyImportanceFollow up affects outcomeKnow what to doWhere is follow-up most appropriate?
Brainstorm
What conditions are important under these criteria?
Perhaps
DiabetesAsthmaCOPDHypertension? EpilepsyHigh risk drug users ie DMARDs etcContraception
CDM Payments
AsthmaDiabetesSmall fee per GP per yearCriteria to claimRequirement for audit
Ways and Means
OpportunisticDedicated clinicsNurse led clinicsSpecific appointmentsDisease registersProtocolsGuidelines
Better Care or Just PC
Sometimes hard to tell!Evidence for effectiveness?Need for auditMore workMore treatment
More iatrogenic problems?
Polyclinic Model of Care
The list of things can grow and grow.Advantages.Disadvantages.Professional satisfaction.Quality.Fragmentation.Fall between two stools.
Generalist Model
Copes with everything.Advantages.Disadvantages.Professional satisfaction.Holistic.Failure to care systematically.
Registers
Creation.Maintenance.Accuracy.Usage.Whose responsible?Manual viz. Computer.
Protocols
Authority.Ownership.Access.Who follows.Benefits.Disadvantages.GOBSAT viz. EBM.
Records
Whose responsible?Paper or computer?Accuracy.Meaning.Why poor?
Audit
PC or use?Who does?More work for what value?Do people change as a result?
