Presenting his 'Next Stage Review', health minister Lord Ara Darzi told MPs that he wants NICE to decide what should be included in the QOF, with a focus on prevention and wellbeing.

Cost-effectiveness and the impact of interventions on the 'health of the nation' are the important deciding factors he said, adding that no extra quality points would be made available to incentivise new indicators.

An official announcement on areas to be included in the QOF has not been made. But health secretary Alan Johnson has highlighted obesity as a key contender.

'We're ensuring we're not overloading the QOF system, but, yes, (obesity is) a crucial part,' he told the Fabian Society last month.

Experts have also called for sexual health to be added to the framework. Ruth Lowbury, from the Medical Foundation for Aids and Sexual Health, said the QOF review was an opportunity to do this.

Both obesity and sexual health were mentioned in the 'Next Stage Review' as two of six key goals of PCT commissioning. Reducing alcohol harm, treating drug addition, cutting smoking rates and improving mental health also featured.

Martin Gray, a nurse practitioner in West Yorkshire, welcomed the shift to preventive medicine. 'We should be proactive, not reactive,' he said. 'Preventive medicine is a key part of a nurses' role.'

Its inclusion in the QOF will mean practices will be paid for preventive work they already do, he added.

Lord Darzi's plan for NICE to overhaul the QOF could end the UK-wide GMS contract, as NICE only provides advice for England and Wales.

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