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GP's fury as PCT dictates therapy

The GPC has urged practices to add a caveat when answering a disputed new question on advance booking in monthly primary care access surveys.

The caveat would enable them to protect quality pay while registering their objections to the question.

The attempt to measure how far in advance practices offer appointments is the latest move by the Department of Health to stop surgeries restricting patients from making appointments in advance ­ despite practices only doing so to offer 48-hour access.

GPC deputy chair Dr Laurence Buckman said GPs were not obliged to answer the question as it exceeded contract requirements for meeting the directed enhanced service on access, and could cause confusion around achievement of access quality points.

With some PCTs warning earlier this year they would dock access quality pay if GPs continued to restrict booking, GPs should add a caveat stating their answer should not affect targets or pay. GPs can each earn £1,666 in access pay and £1,250 in quality pay by hitting the targets.

Dr Buckman said: 'The law says what you have to do and not do. If you fulfil the access targets according to the contract, then that's it.

'We dispute the legality of the question, but to prevent GPs being embarrassed and finding payments have been interfered with, we advise they answer and add a caveat.'

He added it was a 'manifest nonsense' for GPs to offer both 48-hour access and unlimited booked appointments.

Dr Stephen Amiel, chair of Camden and Islington LMC, said the Government clampdown was 'a knee-jerk response to solve a problem it created in the first place'.

A spokesman for Camden PCT admitted 48-hour access targets had 'substantially reduced' the number of advance bookings, but said it would help practices address the problem.

Other London PCTs said they would take a 'developmental' approach with practices that found it difficult to offer bookable appointments.

Dr Michael Taylor, chair of the Small Practices Association and a GP in Heywood, Lancashire, lost out on £2,000 because he ran open surgeries, which do not qualify for 48-hour access.

By Nerys Hairon

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