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CHI 'judging data more than GP care'

Government inspectors who are monitoring GPs' performance against national service framework targets face an 'uphill struggle', research reveals.

GPs may be judged more on their data collection skills than the quality of care they provide because of the practical hurdles that stand in the way of robust monitoring, warned the leaders of the Government-commissioned study.

Their health technology assessment highlighted GP hostility to 'external policing' and variations in practice IT systems as key barriers and concluded that the NHS is not ready for routine monitoring.

The Commission for Health Improvement and the Audit Commission have a statutory duty to monitor GPs' progress towards NSF targets, with a national audit of CHD care already under way.

Professor Allen Hutchinson, professor of public health at the University of Sheffield and leader of the research, said the problem may also prove significant when GP performance has to be measured against the quality and outcomes framework to determine their pay under the new contract.

'There is a risk that people will be judged on the quality of their record keeping rather than on what they deliver to their patients,' he said.

A key problem identified by the study was the diversity of computer systems in common use in general practice.

The researchers concluded it was unrealistic to expect adherence to guidelines to be monitored using computer data: 'The technology for monitoring was absent in many practices. Paper systems are likely to feature for some time to come.'

GPC negotiator Dr Laurence Buckman questioned whether the monitoring of GPs' use of guidelines was really aimed at improving quality. 'PCTs and others want to monitor use of guidelines for some other purpose.

'Following guidelines is not necessarily a marker of quality. Guidelines are not there to police GPs but are there to allow GPs to provide quality care and ensure better outcomes for their patients.'

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