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GP quality payments for asthma to hinge on structured care

Minimum care standards set out in the new national asthma guidelines will form the benchmarks GPs will have to meet to get quality payments under the new contract, negotiators have indicated.

The asthma element of the quality and outcomes section of the contract was a stumbling block during negotiations but a deal has been struck to base payments on some of the standards laid down in the revised British Thoracic Society guidelines.

The guidelines, published in Thorax (February) urge GPs to identify high-risk patients who should be targeted for special review, to undertake regular monitoring of asthma control and to establish systems to ensure their practice offers structured asthma care (see box).

Dr Tony Snell, co-deputy chair of the NHS Confederation core negotiating team, said some of the benchmarks would be included in the contract.

He said: 'Certainly there is a real thrust that practices should follow national guidelines. We can't insert specific recommendations because they may not be measurable. What I can say is that the GPC, the confederation and our expert advisers considered very carefully and are cognitive of what was in the recommendations.'

Dr Dermot Ryan, a GP in Loughborough, Leicestershire, and a member of the asthma guidelines executive committee, said 're-visiting' the diagnosis of asthma, particularly in pre-school children, was vital to rule out other causes such as viral-induced wheeze.

He added: 'Monitoring the use of ?-2 agonists is a good way of picking up patients who are non-compliant.'

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