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Exception report threat

Expert advisers on the QOF review have advised that exception reporting should be scrapped for some diabetes indicators to avoid compromising the care of the most vulnerable.

Pulse uncovered the recommendations as a study found exception reporting rates for diabetes were particularly high in deprived areas, adding to concerns over the current system.

In a report to negotiators in advance of last year's review, the QOF expert review panel advised that the 'scope for [exception

reporting] should be reduced'.

The group expressed particular concern over exceptions on maximum tolerated dose and failure to attend.

Dr Jonathan Graffy, a member of the diabetes expert group and senior clinical research associate at the University of Cambridge, said: 'We were concerned about non-attendance. It would be very important to know for the next review what had actually happened [with exception reporting].'

Dr Graffy, a GP in Histon, Cambridgeshire, added: 'If we had 100 per cent upper limits, exception reporting would be necessary but the thresholds have some leeway.'

A new study published online by the Journal of Public Health found in 10 of 15 diabetes in-

dicators examined, exception reporting was related to deprivation.

But Dr Neil Munro, a GP in Claygate, Surrey, and associate specialist in diabetes, said: 'It could produce perverse pressures on practices.'

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