UK Update

DH consults on GP incentive scheme

The DH has launched a consultation to discuss proposed changes to the Quality and Outcomes Framework (QOF). The consultation, which closes on 2 February 2009, will address health inequalities and discuss how the new process for assessing evidence for QOF indicators should work.

The consultation will also discuss how best to:

• Review existing QOF indicators
• Develop new indicators for clinical quality and health outcomes, based on evidence of clinical effectiveness
• Allow a range of stakeholders to identify potential QOF priorities
• Appoint a panel of independent experts that will identify areas for new indicators
• Trial new indicators with GP practices
• Give flexibility to local NHS authorities to select some indicators to reflect individual health needs.

More information: www.dh.gov.uk

GMC launches "Help for witness" guide

The GMC has published a booklet to provide advice for witnesses attending a GMC hearing. The “Help for Witnesses” guide provides information on:

• What witnesses will need to do on arrival at the hearing centre and whilst waiting to give evidence
• Who will attend the hearing
• What happens if there are any confidential matters to discuss
• Terminology that witnesses may not be familiar with
• The centre that the hearing process will take place in, including directions and maps.

The guide also provides an opportunity for witnesses to feed back any comments on their experience, to help the GMC monitor and review the process.

More information: www.gmc-uk.org

New cremation rules allow families to access forms

New cremation regulations will enable bereaved families to inspect both the medical certificate and confirmatory medical certificate of a deceased family member before a cremation takes place. This is to dispel concerns that discrepancies might not be brought to the medical referee's attention.

The new guidance will consolidate all previous regulations, replacing the amended Cremation Regulations that were first produced in 1930. They should be considered to be an interim measure pending DH plans to appoint a Medical Examiner, who will deal with all deaths. The cremation regulations came into force on 1 January 2009.

More information: www.justice.gov.uk

NICE guidelines for prevention of osteoporotic fractures

NICE has issued new guidance on medication to prevent osteoporotic fractures in postmenopausal women. The guidance recommends which drugs should be used to prevent a first osteoporotic fracture, and which should be used for patients who have suffered fractures before.

The recommendations state that alendronate should be used to prevent osteoporotic fragility fractures in women aged 70 years or older, who have low bone mineral density (BMD) and who have been diagnosed with osteoporosis.

Alendronate can also be used for preventing fractures in postmenopausal women up to the age of 70 who have osteoporosis and:

• An independent clinical risk factor for fracture for those aged 65–69 years
• An independent clinical risk factor for fracture and at least one additional indicator of low BMD.

Alendronate can also be used to prevent the re-occurence of osteoporotic fractures in postmenopausal women of all ages. NICE recommends risedronate and etidronate as substitute medications for women who cannot take alendronate, but warns against the use of raloxifene in primary prevention of osteoporotic fractures.

More information: www.nice.org.uk