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Better by phone than not at all

GPs may be pretty used to daft decisions these days, but this week's ruling on telephone reviews in asthma must still have raised an eyebrow or two. An arbitration panel chose to ignore the advice of respiratory experts and decide that reviews over the phone could no longer count towards QOF points.

GPs may be pretty used to daft decisions these days, but this week's ruling on telephone reviews in asthma must still have raised an eyebrow or two. An arbitration panel chose to ignore the advice of respiratory experts and decide that reviews over the phone could no longer count towards QOF points.

Phone reviews have been a source of contention for some time now, since a group of PCTs first began refusing to pay out to GPs who reviewed their patients at the end of a line. Managers argued that it was hard to check inhaler technique over the telephone. They questioned whether the evidence for phone reviews was applicable to all GPs. Mostly, they felt a review over the phone was just not the same as an all-singing all-dancing consultation.

Reality facing GPs

And of course they are right. Face-to-face is better. Just like a night out with friends beats a snatched conversation on the mobile. But this is not the reality that faces GPs. A good number of asthma patients do not regard themselves as terribly ill and have better things to do than come into the surgery. So the choice is not between telephone review or face-to-face consultation. It is telephone review, or no review at all.

Where GPs once had an incentive to track down and review their patients, now many will simply exception report all those who refuse to attend the surgery.

An incentive to do more will have just the opposite effect.

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