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Exception reporting rules to be toughened

By Lilian Anekwe

Ministers plan to tighten the rules on exception reporting amid continuing concerns over GPs gaming the contract.

The Department of Health wants to reduce the number of valid reasons for exception reporting by scrapping softer justifications such as missed appointments, Pulse has learned.

A source close to the review of the quality framework told Pulse that ministers proposed to reduce the number of reasons for exception reporting from about 10 to five or six.

Dr Tim Doran, clinical research fellow in public health at the National Primary Care Research and Development Centre, suggested GPs might no longer be allowed to exception report patients who had been invited to a practice three times but had not turned up.

He said: 'I know the department is trying to crack down. In future QOFs you might not be allowed to exclude for as many reasons. At the moment there's about 10, but that might be cut to five or six.' A second source close to the department confirmed proposals on exception reporting were under consideration.

Dr Doran added: 'At the moment you've got two mechanisms for ensuring patients who don't need treatment are not treated ­ maximum thresholds and exception reporting. Do you really need both?' Dr John Guy, a GP in Hatfield Peverel, Essex, and clinical lead for EQUIP, which monitors exception reporting rates, suggested publishing 'name and shame' league tables instead. 'If people know that's happening, they might play ball,' he said.

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