GP Practices to be Offered Incentives to Screen Elderly People for Atrial Fibrillation

New NICE plans will see GP practices offered incentives through QOF to screen elderly people for atrial fibrillation.

30 GP practices will carry out twice yearly pulse checks as part of this new initiative.

The scheme is intended to ensure that surgeries detect heart arrhythmia at an earlier stage.

NICE note that up to 470,000 adults with atrial fibrillation have not been diagnosed.

And the regulator NHS Improvement have suggested that 8,000 extra strokes could be prevented annually by improved management of the condition.

Not only would this save lives, but the financial saving for the NHS could be in the region of £100 million every year.

It is hoped that this new process could be rolled out in 2017/18.

However, GP leaders have certainly not fallen in line with the new regulations without comment or criticism.

Dr Andrew Black, a GP in Herefordshire and deputy chair of the indicator advisory committee, asserted that the new measures to improve the fibrillation process would have a significantly positive impact on patient safety.

“Improving the identification of atrial fibrillation and ensuring we perform timely reviews of treatment are two very easy steps we can take, which could have a huge benefit to our patients. I am glad these indicators are being piloted and I look forward to reviewing the impact they have had.”

Dr Peter Swinyard, chair of the Family Doctor Association, was sceptical about the changes, suggesting that they are overly bureaucratic and not necessarily vital to patient safety.

“It’s another box to tick , when you get these extra boxes to tick in certain groups – but does that really save lives? We do pick people up – we do already check the pulse – and I’m not sure giving us yet another hurdle to jump is going to help anything at a time when we are so short on appointments and manpower.”

And an expert from the Royal College GP’s group on overdiagnosis asserted that the approach “is a proposal to screen for atrial fibrillation” and that “NICE should not be promoting a screening activity that has been considered by the National Screening Committee and rejected”.

However, the NICE indicators advisory committee discussed the matter during a recent meeting, and concluded that such concerns were ill-founded.

NICE believe that said yearly pulse checks should not have “major implications on resources as this process should be done when carrying out other processes such as blood pressure checks”, and that, “it does not constitute screening”.

And it ruled the yearly anticoagulation review “would not be captured in a generic indicator on medication review”.


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