Proteinuria is expected to be added to the chronic kidney disease domain of the QOF in this financial year, ie to apply from 1 April 2008.
As part of the negotiations on the General Medical Services contract for the financial year 2008/09, NHS employers have been consulting the General Practitioners Committee (GPC) on changes to the Quality and Outcomes Framework. The results of the pole of all GPs which GPC carried out was in favour of accepting the proposals which NHS employers put to the GPC. The negotiating parties are now working toward the practical implementation of these proposals.
For Chronic Kidney Disease CKD 4 will be amended and renumbered as CKD 5 to only include those patients with hypertension and proteinuria as detailed in the CKD frequently asked questions.
CKD 5: The percentage of patients on the CKD register with hypertension and proteinuria who are treated with an angiotensin converting enzyme inhibitor (ACE) or angiotensin receptor blocker (ARB) (unless a contraindication or side effects are recorded).
There are other significant changes to QOF to reallocate points to reward patient satisfaction with access, through new QOF indicators in the patient experience domain. Proposed changes to the financial and accounting arrangements are also being considered.
Taken together with the NICE Guideline, currently out for consultation, I think it is fair to consider 2008 as the year of proteinuria or should I say the year of urinary albumin creatinine ratios.