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GPs face huge bill for disease register set-up

Practices may have to spend tens of thousands of pounds to set up disease registers under the new contract ­ and they won't qualify for any quality outcome points until they have done so, GP academics warn.

Estimates of the bill facing practices have sparked complaints that the quality preparation payments are too small.

Small practices claim they will be worse off as larger practices can spread the same work over more staff.

Research suggests setting up a heart failure register alone can cost up to £2,300. Under the quality framework, practices have to set up 11 disease registers ­ one for each of the 10 disease areas plus one for left ventricular dysfunction. Preparation payments will average £3,000 per GP per year.

Dr Frances Mair, senior clinical lecturer in general practice at the University of Liverpool, said her research showed the cost of setting up accurate and auditable heart failure registers ranged from £178 to £2,300 per practice, depending on list size. Up to 17 days of nurse and clerical time was required.

Dr Mair, a GP in Merseyside, said the preparation payments would not cover the cost of setting up accurate registers for all 11 conditions.

She said: 'If you pay the kind of money on offer, disease registers will be produced but they won't be accurate. Accuracy will cost a lot more.'

GPs must set up disease registers before they can claim any payment for hitting pro-cess and outcome targets.

Dr Michael Taylor, chair of the Small Practices Association and a GP in Heywood, Lancashire, said small practices faced disproportionate costs. 'If you're a practice with four to six burnt-out GPs you get the dilution effect of your colleagues. Burnt-out singlehanders have no dilution effect.'

GPC negotiator Dr Andrew Dearden said GPs should set up registers using Read codes and add to them. 'The registers will be generated by day-to-day consultations.'

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