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GPs face postcode lottery on disciplinary referral

By Gareth Iacobucci

GPs face starkly different odds of being hauled before a national disciplinary and retraining body depending on where they practise, Pulse can reveal.

Referrals to the National Clinical Assessment Service between 2001/2 and 2007/8 show almost a threefold variation by SHA, suggesting likely inconsistencies in the ways GPs are dealt with by PCTs.

There was a similar variation in rates of GP suspension.

The release of the figures to Pulse by NCAS follows RCGP chair Professor Steve Field's warning that some PCTs had unusually high rates of NCAS referral.

The variation is likely to heighten concern over inconsistencies in the quality of GP appraisal, which is contributing to delays in plans for revalidation.

NHS South West had the lowest NCAS referral rates, averaging 57 a year, compared with 144 at NHS North West and 137 at NHS North East.

The NCAS ‘risk index' for likelihood of suspension also varied widely, from 37 for GPs in the South-West to 161 in the North-East and 129 in the North-West.

An NCAS report concluded: ‘We need to consider why GP suspension is showing different geographical patterns', warning it could be because of a lack of guidance to ensure consistent standards between regions.

Dr Sella Shanmugadasan, chair of Tower Hamlets LMC, said the current process was very subjective: ‘It's not a true reflection. If the PCT doesn't like a certain section of people, they can [refer them]. I would like the process to be far more objective.'

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