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GP alarm over pharmacists switching epilepsy drugs

By Ian Cameron

The number of GPs being investigated for supposed poor performance has jumped by more than 60 per cent in the past year, new figures reveal.

Statistics obtained by Pulse from the National Clinical Assessment Service show it received 309 referrals about GPs in the year to October. This compares with 193 in 2003/4 and only 122 in 2002/3.

GPs also represented an increasingly large proportion of referrals, accounting for 44 per cent of cases last year, up from 39 per cent in 2003/4.

NCAS was set up in 2001 in the wake of the Shipman case to enable investigation and retraining of poorly performing doctors without having to refer them to the GMC. But GPs said the process was still 'highly stressful' and questioned whether PCTs were using the system properly.

Only one in 10 referrals was taken on to full assessment by NCAS, while the rest were referred back to trusts with advice on how to proceed.

Professor Martin Roland, director of the National Primary Care Research and Development Centre, said the figures indicated PCTs were becoming less confident dealing with complaints.

He said: 'There's no reason why GPs have got worse so it implies there's something happening at trust level in their ability to assess cases.'

Dr Chris Woods, a GP in Bolton, said a GP friend was facing an imminent NCAS assessment as a result of a minor complaint. He said practices did not know whether NCAS's role was supportive or punitive and medicolegal bodies appeared reluctant to help.

'Doctors are put under a very intensive investigation,' he said. 'The team arrives for three days and goes through the practice with a fine-toothed comb. It's very stressful.'

Dr Peter Schütte, medicolegal adviser at the Medical Defence Union, said its role was limited: 'We can offer moral support and explain procedures, but a representative can't intervene and act as an advocate.'

A spokeswoman for NCAS said most referrals did not require a full assessment and were handled by mediation, advice and guidance.

Of the first 50 cases that went to a full assessment, 21 resulted in action plans specifying retraining. Five were referred to the GMC.

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