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Annual review plans 'breach light-touch contract pledge'

GPs face 'bureaucratic' and 'disruptive' visits by large teams of assessors as part of the annual review of quality and outcomes measures.

Under new Government guidance issued to PCTs, all practices will have an annual review visit of at least half a day – and while many practices will be assessed by a team of three visitors some could be examined by eight or more, including prescribing advisers and IT specialists.

Thousands of GPs each year will also face random spot- checks under a plan to subject one in 20 practices a year to further scrutiny specifically to curb fraud.

The annual visits could also force the GP appraisal system to be suspended between October and January to 'ensure the burden' on GPs willing to act as quality assessors 'is spread', the guidance said.

All practices will have to submit written evidence to their PCTs a month before the review visit, covering all exceptions used for each indicator in the framework. Assessors will then perform 'some form of verification of exception reporting' during the visit.

GPs argued such intense scrutiny would betray the 'light touch' promise that accompanied the new contract.

Dr Ruban Prasad, GPC member and a GP in Preston, said: 'It defeats the whole purpose of high trust working. It is only fair that we should be reasonable and transparent but it doesn't have to be bogged down in bureaucracy.'

And Dr Rob Barnett, Liverpool LMC secretary and a GPC member, said: 'Having all sorts of people coming in and trawling over things with a magnifying glass is not going to be helpful to anyone.'

On the potential impact on appraisals, Dr Barnett added: 'We spent a lot of time trying to encourage GPs to get involved in the process and if it is now not seen to be a priority then that is giving the wrong impression. It is the wrong advice at the wrong time.'

But Dr Ian Trimble, a GP in Nottingham and Government adviser on quality and outcomes, said the visits would not be based around 'judgmental verification'.

PCTs did not have the manpower to scrutinise all practices closely and tight scrutiny would go against the 'light-touch' approach, he added.

By Cato Pedder

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