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Confusion over contract informed dissent rules

Confusion has emerged on what steps GPs will have to take before they can report women as informed dissenters for cervical screening under the new contract target pay system.

The disagreement between the GPC and NHS Confederation blew up after official statistics revealed falling smear uptake in younger women.

GPC negotiator Dr Laurence Buckman said GPs' target pay would not be hit as the guidance on informed dissent was 'crystal clear'. He insisted GPs could exception report any woman who 'failed to respond' to invitations.

But the NHS Confederation said GPs would need to get active confirmation that a woman did not want screening before exception reporting them. A spokesman said he 'didn't think' failure to respond to an invitation would amount to informed dissent: 'The confederation assumes the PCO would check a sample of patient records to ensure data is correctly recorded.'

Government statistics show the proportion of women in England aged 25-29 screened in the last five years has fallen to 73.8 per cent ­ down from 75.0 per cent last year and 79.7 per cent in 1995.

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