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GPs are facing a postcode lottery over exception reporting with practices in different areas likely to face widely varying degrees of scrutiny in the looming quality framework annual visits.

LMCs claimed the absence of national guidance had thrown GPs into confusion over the rules while PCT

quality and outcomes leads said they were 'not happy' that the Government was forcing them to arrive at solutions


Dr David Alexander, a GP in Dunfermline and member of the Scottish national quality and outcomes implementation group, said there had been no training at all on what exception reporting was appropriate and that he felt 'sympathy' with GPs over the chaos.

And Reading PCT Q&O lead Marilyn Read said: 'We've been told it is up to us how it is interpreted but the codes need to be specific.

'There is no need for this to be decided locally, there should be national guidance, which at the moment there isn't.'

Sources close to the Department of Health believe it will issue belated guidance to PCTs in the next few weeks on how to spot 'inappropriate exception reporting' during quality visits.

But GPs are furious that they have been left in the

dark over what level of ex-

ception reporting is per-

mitted and will face quality

visits without any clear guidance.

PCTs said they would scrutinise GPs' rates of exception reporting during the forthcoming visits and would investigate inconsistencies between practices if necessary. They warned any inappropriate use of the system would be 'weeded out'.

Gloucestershire LMC has collated a list of 25 clinical areas where confusion is rife, including drug intolerance in hypertension, use of ?-blockers in patients with asthma and needle phobia in patients requiring blood tests.

And LMCs plan to rally to the defence of GPs who use mass exception reporting where appropriate.

Dr Brian Balmer, GPC member and chair of Essex LMC, said PCTs were being 'devious' and should 'stop looking for things that aren't there and get on with their jobs'.

By Pulse Reporters

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