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GPs resist threats to quality freedom

GPs are vowing to resist primary care organisation moves to curtail their freedom to set their own workload under the quality framework.

The defiant stand came after it emerged PCOs will be performance managed by the Commission for Health Audit and Improvement on GPs' performance against the framework.

The NHS Alliance has predicted it is a 'dead cert' that CHAI will make PCOs' quality performance a star-ratings indicator, putting pressure on managers to maximise how many points GPs achieve.

But GPC negotiators stressed PCOs have no right to dictate how practices approach the quality framework.

Dr Brian Patterson, GPC Northern Ireland chair, said 'the essence' of the contract was that practices control their workload.

He added: 'No matter what star ratings they have or the

financial implications, PCOs don't have the authority to ask practices to do something faster than they might want.'

Norfolk LMC chair Dr Ian Hume said GPs had to 'take the contract at face value'.

'One of its fundamental tenets is to enable practices to control their workload, to keep it under control and not be pressurised. They have got to make use of that,' he added.

Other GPs said PCOs would either have to look elsewhere if they wanted to improve services more quickly than GPs were willing to go, or pay more for each quality point achieved.

Gloucestershire LMC secretary, Dr John Peniket, said: 'Using alternative ways of tackling shortfalls in quality targets is not going to be as effective as paying GPs to do it. One way could be to pay more per quality point.'

Some GPs said pressure on PCOs could mean they would give GPs more support to achieve their aspirations against the framework.

Dr David Jenner, NHS Alliance contract lead and a GP in Cullompton, Devon, said it was a 'PCO's job' to help a practice meet its quality targets if it was struggling. 'That could mean helping with workload and looking at whether there are any barriers to recruiting,' he said.

 · Comment, page 22

PCOs must ask why and hopefully that will stimulate discussion with practices,' he said.

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