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At the heart of general practice since 1960

DH to launch national practice league tables next year

By Jo Haynes

Patients will get access to league tables ranking every GP practice against 101 clinical and organisational quality markers in the New Year.

The Department of Health says the new performance data will also give PCTs a new tool to drive up the quality of GP services by allowing trusts to compare individual practices against local and national benchmarks in unprecedented detail.

But some GPs and practice managers warned the move would give trusts ‘a big stick to beat GPs with'.

Every practice in England will be graded green, amber or red on each of 101 indicators in the new data, due to be published on the Information Centre website in January under the NHS Comparators banner.

The indicators include clinical markers such as the proportion of patients hitting blood pressure and HbA1c targets, efficiency markers such as the proportion of drugs prescribed generically, and patient satisfaction ratings such as access and the quality of GPs' communication skills.

Patients and trusts will be able to see which percentile, from 1 to 100, any given practice falls into when ranked against others in the PCT or against all practices in England.

Practices will also be put in one of four categories for each of the 101 indicators [see below].

Jill Matthews, the DH's national implementation director for primary care and community services, told the NAPC annual conference in Birmingham that PCTs could use the tool to identify high-performing practices that were best placed to provide new services – and to pick out struggling practices that needed support.

‘It's not about saying this practice is good and another one bad,' she said. ‘It's about getting PCTs and practices talking and working together.

‘But as a PCT, if I see three practices that are doing less well on a particular indicator than last year, I would want to know why.'

She said all the raw data was already in the public domain but this would be the first time it had been brought together in one place with tools enabling PCTs and patients to compare practice performance in detail.

She added: ‘There is a view that all of this information should be on NHS Choices so that as we move to a world where practice boundaries aren't an issue, patients can use it to choose their practice.'

But she added: ‘We need to put the right language around the data, to tell patients not to panic about their practice.'

Ms Matthews said giving PCTs the ability to compare practices against others with a similar patient demographic would put an end to practices claiming they had scored poorly on a given indicator because of their challenging patient population. ‘The PCT can compare that practice against the 40 other practices in England with the most similar demographic and show they all scored dramatically better. That's very powerful, especially on clinical indicators.'

But Ray Guy, a practice manager in Liverpool, warned: ‘Some PCTs will inevitably use this as a stick to beat practices with, however much you tell them it's not about that.'

He added: ‘They won't take account of variations in funding. I know practices that get £50 per weighted capita and others that get £150 but that won't be shown.'

Ms Matthews said pilot work in several PCTs had shown there was little correlation between funding and quality. ‘Some of our poorest funded practices are doing phenomenally well and some of our highest funded practices are doing much less well. PCTs will want to ask what the extra £100 per patient they are putting in to a practice is achieving in terms of lower referrals or better outcomes.'

She said detailed referral rates for individual practices would be added to the performance data in the second phase.

Patients will be able to compare their practice against every other practice in the country Patients will be able to compare their practice against every other practice in the country How practices will be rated

Practices will be put into one of four performance categories for each of the 101 indicators:

- top-performing practices - rate above average and are still improving
- 'coasting' practices - rate above average but are going downhill
- improving practices - are below average but getting better
- struggling practices - are below average and falling further

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