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DoH moves to close local quality loopholes

GPs are set to sweep the board on quality points for CHD and hypertension after the first audit of achievement found they were hitting even the toughest of targets.

The research found practices were on course for maximum CHD points in cholesterol control, betablocker use and flu immunisation, and even blood pressure control in hypertensive patients ­ making a mockery of warnings that the target was unachievable.

The study provides the first evidence that the new GMS contract is having the prom-ised effect on the quality of care, with the GP researcher claiming standards had improved 'unbelievably' since April.

Dr Mark Samuel, who presented the results at last week's British Cardiac Society conference in London, said: 'If you give GPs a target they will do it. GPs were expected to get 750 points but I doubt that any GP will get under 900.'

Dr Samuel, a GP in Pontypridd, South Wales, admitted hitting targets had been harder for singlehanders but said they were still on course to score well. 'Singlehanders are hardly likely to employ a £30,000-a-year practice manager and small practices with a high proportion of CHD will have a lot of work to do on their own. But by April I'm sure everybody will be within a couple of per cent of targets.'

Dr Samuel audited the care of 100,000 patients in 15 practices in Wales up until the end of January, in order to provide the first indication of GPs' quality achievements.

In 65 per cent of hypertensive patients, blood pressure had already been controlled below 150/90mmHg, with the figure set to be well over 70 per cent by the end of March.

This had been accompanied by a 20 per cent increase in prescribing rates for hypertension medication.

Cholesterol levels had been reduced below 5mmol/l in more than 60 per cent of CHD patients and over 50 per cent were on a betablocker and over 70 per cent on an ACE inhibitor.

GPs had also hit 90 per cent targets for referring patients with newly diagnosed angina, recording smoking status and offering advice, recording blood pressure in CHD and hypertension, prescribing aspirin in CHD and confirming left ventricular dysfunction.

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