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Double dealing

First we had gaming, now we have double counting.

First we had gaming, now we have double counting.

Ministers continue to gripe about alleged abuses of exception reporting, but they now mutter equally darkly about a new flaw in the quality and outcomes framework, supposedly allowing GPs to be paid twice for some cardiovascular indicators.

The murmurings Pulse reported earlier this year are now solidifying into a concrete plan to squeeze yet more from general practice, with a swathe of CVD points set to make way for brand new clinical domains.

GPs can expect not so much an overhaul of the QOF in the coming review, as a full frontal assault on the principle of no new work without pay that was supposedly enshrined in the GMS contact.

With public support eroded by a year of negative spin, ministers will be counting on the profession to be too weak to put up a fight.


Perhaps, though, the Government may have miscalculated, for it does not seem to have realised just how successful its campaign to punish GPs for over-delivery on the contract has already been. Profits are down by more than 10% over two years at most practices, and by as much as 42% in a few.

QOF scores, while still impressively high, have fallen with the introduction of the last round of clinical indicators.

It is time the profession said enough is enough, and made clear it cannot take on more work without fresh resources. Perhaps, in new GPC chair Dr Laurence Buckman, GPs may finally have found a man willing to put his foot down.

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