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GPs reject advice to forget NSFs and get quality points

GPs have denounced GPC advice to ignore national service frameworks in order to maximise their income under the new contract.

Negotiators have recommended GPs only do work that can net them points under the quality and outcomes framework. Dr Simon Fradd, GPC joint-deputy chair, said any activity outside the quality framework was 'irrelevant'.

But GPs said NSFs were 'good blueprints for medical care' and they could not ignore something that might benefit patients.

Professor Martin Roland, director of the National Primary Care Research and Development Centre, and a GP in Rusholme, Manchester, said GPs' professionalism wouldn't allow them to ignore NSFs.

'Nobody is suggesting the only work in general practice should be in the quality and outcomes framework,' he said. 'In many cases NSFs reinforce what we know to be good medical practice, so future ones won't be redundant.'

Other GPs said many of the quality markers for coronary heart disease and diabetes overlapped with NSF targets.

Dr Arnold Zermansky, a GP in Leeds, said: 'If you are assiduously following NSFs it's likely you would be pretty good at achieving quality: the converse is true as well.'

North Devon LMC chair Dr Mark Wood said it would be difficult for GPs to ignore NSFs but they could stop doing the 'copious amounts of politically-driven' work for

NSFs, such as counting the number of falls in older people.

Liverpool LMC secretary Dr Rob Barnett said GPs should prioritise the quality framework but this may not mean neglecting NSFs: 'If you concentrate on the quality framework you will go some way to achieving NSF targets.'

The Department of Health said it expected the quality framework to 'aid delivery of NSF targets' and NSF work would inform future changes to the quality framework.

'Neither the NSFs nor the quality framework are static,' said a spokesman. 'New NSFs will be coming along and we will determine ways to update the quality framework taking new methods of evidence-based practice, including from NSFs, into account.'

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