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<p>Epilepsy is allocated one achievement point within the Quality and Outcomes Framework
(QOF) in the General Medical Services Statement of Financial Entitlements (Amendment)
(No.2) Directions 2022. QOF clinical indicators are subject to approval by the National
Institute for Health and Care Excellence (NICE) and are underpinned by NICE clinical
guidelines and are subject to consultation with the General Practitioners Committee
of the British Medical Association.</p><p>Sodium valproate must not be used in any
woman or girl able to have children unless she has a Pregnancy Prevention Programme
in place. This is laid out in guidance issued by the Medicines and Healthcare products
Regulatory Agency, last updated in February 2021, which can be found at the following
link:</p><p><a href="https://www.gov.uk/guidance/valproate-use-by-women-and-girls"
target="_blank">https://www.gov.uk/guidance/valproate-use-by-women-and-girls</a>.</p><p>The
programme is designed to make sure patients are fully aware of the risks and the need
to avoid becoming pregnant. It includes the completion of a signed risk acknowledgement
form when their treatment is reviewed by a specialist, which must take place at least
annually.</p><p>A Valproate Registry has been set up which, in line with a recommendation
of the Cumberlege review, has been extended to other antiepileptic drugs taken during
pregnancy. It includes all women in England who are taking National Health Service
(NHS) prescribed valproate and identifies when they are pregnant and accessing NHS
care for that pregnancy. The registry improves our ability to monitor implementation
and compliance with the Pregnancy Prevention Programme.</p>
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