The NHS Alliance has given muted approval to Department of Health proposals to change the quality and outcomes framework GP bonus scheme.

The alliance said it agreed with the DH proposal that framework indicators should be selected by the National Institute for Health and Clinical Excellence.

But in its response to the DH's consultation it says NICE is too "heavily dominated" by specialists, without enough input from GPs, commissioners and the primary care sector.

The DH has also proposed that some framework indicators are based on local priorities.

The Alliance said there was some merit in this provided the chosen indicators were linked to council-led joint strategic needs assessments and made up no more than 20 per cent of all indicators.