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GP backed by PCT on spirometry loophole

GPs can avoid unnecessary reversibility testing for COPD without financial penalty by exploiting a loophole in recent Government Read codes guidance, says Dr Simon Child.

He has received backing from his PCT for his belief that practices do not need to exception report COPD patients diagnosed without reversibility testing. Bury PCT said this was a 'reasonable interpretation' of the latest technical guidance from the Department of Health.

The issue has proved controversial since NICE advised earlier this year that reversibility testing was not necessary to

diagnose COPD despite the quality framework appearing to require it.

Dr Child, a GP in Bury, said: 'There is no need to record both reversibility and spirometry – either or both will do.' By not exception reporting GPs would avoid losing quality points.

But GPC negotiators and the NHS Confederation disagreed, insisting GPs should still exception report where reversibility testing was not needed.

GPC deputy-chair Dr Hamish Meldrum said some chest physicians still felt reversibility testing was necessary and there would be no 'tinkering' with the framework.

The NHS Confederation said GPs should either conduct reversibility testing or exception report.

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