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Dr Tim Scott has calculated that his practice will lose out on more than £35,000 in quality pay because of the factor used to compress disease prevalence.

Dr Scott said the square root correction factor used to even out the distribution of money was 'unnecessary, unfair and unprecedented'.

Using disease prevalence data his PCT obtained from the RCGP, he calculated that his practice in Tibshelf, Derbyshire, was likely to get £35,290 less than it would if no correction factor was applied.

Dr Scott said his practice was particularly badly hit on hypertension, where his prevalence is more than three times the national average. He said: 'The reasons they gave for using the formula are that set-up costs ­ which are one-offs ­ are equivalent. That's rubbish. The workload is directly proportional to the number of patients.'

Dr Hamish Meldrum, GPC chair, denied that those with higher prevalence needed proportionally higher pay. 'I don't think the workload involved for 100 diabetics is double that of 50. Every practice has to do some work just to find the first diabetic.

'Obviously the present Q&O and the square root formula apply this year and almost certainly next year ­ but we will look at it.'

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