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Independents' Day

GPs to be paid according to traffic-light ratings

By Gareth Iacobucci

The Government is planning for GPs to be paid by their performance on its controversial practice scorecards, as a way of driving improvements through World-Class Commissioning.

The proposals would offer incentives to practices scoring well on balanced scorecards, but could also direct cash at those judged to be performing poorly.

Department of Health guidance issued to trusts urges them to develop incentives both for ‘leading-edge' and ‘struggling' practices, to reward excellence and ‘raise the bar' at opposite ends of the scale.

Trusts are to be expected to use LESs to link pay to performance on the scorecards – marked using traffic-light style ratings – or build requirements into the core specification for PMS or APMS contracts.

It follows plans released earlier this month to give NHS providers who do badly on scorecards two chances to put things right – but to employ a ‘three strikes and you're out' policy.

In the document, the DH explains how PCTs are expected to implement the controversial scorecards, which have already been used to initiate contractual sanctions against GP practices in Barking and Dagenham, as Pulse revealed in May.

It says: ‘PCTs may want to introduce incentives and educational support for both leading-edge and struggling practices. The aim is to raise the bar.' It said scorecards would not be used to determine contractual pay for GMS practices, but trusts would be free to attach incentives to local contracts and LESs.

A DH spokesperson said: ‘It will be for individual PCTs to decide. They may choose to do this by creating local incentives.'

Dr Sarah Smith, a GP in Camden, north London, whose practice was scored above average on most indicators by her PCT, said: ‘I don't think we need it. There is already enough scrutiny and merit-based pay with the QOF and patient survey.'

Dr Karen Benson, a GP in Haringey, north London, said: ‘It's like school league tables – useful but not the whole story. And it's another potentially expensive layer of bureaucracy.'

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