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Commissioning groups urged to closely police GP referrals and prescribing rates

A new report jointly authored by former primary care tsar Professor David Colin Thome recommends GPs should be ranked against each other on their referral rates and prescribing behaviour to ramp up ‘peer pressure' to control costs.

The report by the Intelligent Board, an initiative within Dr Foster Intelligence, said clinical commissioning groups should carry out ‘in-depth' comparative reviews of GP referrals and prescribing every two to three years.

The authors said CCGs should initially encourage analysis as an internal process, ‘but the aim should be to gradually increase transparency and peer pressure'.

The report said: ‘The key challenge is to understand variations between GP practices and individual practitioners, particularly in referral and prescribing habits and the experiences and views of patients.' It advised CCGs to also collect information on GPs' intervention rates.

Professor David Colin-Thomé said: ‘NHS commissioning has achieved less than it should due to a lack of clinical involvement and high-quality information.'

'We should not be distracted by the fact some aspects of commissioning remain to be finalised. Commissioners need to get on and deliver results.' 

But Dr Richard Vautrey, deputy chair of the GPC, said it was ‘potentially dangerous' to make crude assumptions about referral and prescribing behaviour.

Dr Vautrey, a GP in Leeds, said: ‘Many GPs already find it helpful to compare their prescribing and referral data with peers.'

'However variation is often for a variety of complex reasons. It is potentially dangerous  to assume someone with low referral or prescribing is a good practitioner. It could be the reverse.'

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