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GPs set for scorecard based on costs

Exclusive A clinical commissioning group (CCG) is introducing a controversial 'financially driven' balanced scorecard, assessing GP practices against their ability to stay within budgets set them for referrals and prescribing.

Documents from Oldham NHS Clinical Commissioning Group, seen by Pulse, reveal that GPs in the area will be set a package of targets for staying within budget and achieving QIPP efficiency savings, in a move described as 'concerning' by the GPC, which said it could lead to 'unintended consequences'.

In recent weeks Pulse has revealed a number of cases where CCGs have been accused of being too prescriptive about GPs' clinical behaviour, with some GPs being placed under 'special measures' by their CCGs and others restricted to as few as four new referrals a week.

The Oldham CCG minutes state: 'Kath [PCT deputy director Katherine Jones] shared copies  and explained this was the first draft of a financially driven balanced scorecard. Rob [PCT deputy director of finance Rob Fenton] said this was part of an overall information package within the governance structure and a report could be available for each practice.'

The shadow chief operating officer of Oldham CCG, Denis Gizzi, told Pulse: 'It is a mechanism to get practices their cost and activity profile.'

Asked if the scorecard contained a limited budget that individual GP practices were expected to keep within, he said: 'Yes. We¹ve developed a budget.'

Mr Gizzi said there were no sanctions 'yet' for GPs who went over this budget, but that there would be 'obligations' for them to stick to budgets as part of their membership of the CCG.

He said the scorecard would cover four key areas: finance, improvements to patient care and experience, efficiency savings and patient choice.

Dr Richard Vautrey, GPC deputy chair, said: 'It is concerning if PCT clusters are encouraging CCGs to set financial targets for practices. This will undermine the doctor-patient relationship and could lead to serious unintended consequences.'

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