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Long-awaited Government guidance on maintaining patient confidentiality during quality review visits has failed to deliver practical advice, GPs have warned.

With just three weeks to go before the first visits, GPC negotiators are still seeking legal guidance after some trusts agreed that clinical staff who carried out visits would be allowed to view identifiable patient records.

But other trusts claimed this would violate the Data Protection Act.

Problems have also emerg-ed with QMAS, and GPs have objected that the visits could become too bureaucratic.

GPC deputy-chair Dr Laurence Buckman said that while the Data Protection Act implied that assessors should not be able to view identifiable patient records for the quality visits, 'common-sense' implied the opposite.

Dr Buckman said the GPC was urgently seeking legal advice on the issue and that sticking a piece of tape over the top of the computer screen so

assessors could not see patients' names was not a suitable solution.

Dr Charles Zuckerman, Birmingham LMC secretary, said there was a clear conflict between the Data Protection Act and Department of Health guidance, which needed to be resolved. 'Anonymising information will be very difficult and getting patients' consent is going to be an absolute nightmare,' he added.

Dr Niall Finegan, Salford LMC chair, said the Government should have 'the guts' to admit it needed the information to monitor the health service and so the Data Protection Act did not apply.

Some areas are also reporting serious teething problems with QMAS, which they fear will mean review visits will have to be carried out 'blind', as practices will not know how they are performing.

The news comes despite claims from GPC chair Dr Hamish Meldrum that the system was up and running and 'doing well'.

Dr Ivan Camphor, secretary of Wirral LMC, said: 'We are having problems with QMAS and it is going to cause problems with the visits.'

LMCs continued to voice concerns over the 'highly prescriptive' and 'bureaucratic' approach to the visits, which they say contradicts the 'light touch' ethos of the new contract.

Dr Tony Welch, secretary of West Sussex, Kingston

and Richmond, and Croydon LMCs, said: 'Our main concern is the bureaucracy behind it and the training. It is highly prescriptive and high-handed.'

The news came as the Scottish GPC said it was likely that only a random sample of practices there would be visited.

Confidentiality and disclosure of information:

Department of Health code of practice

•Patient health care does require information to be shared appropriately among those who provide that care

•Where information identifies individuals, it is likely to be subject to Data Protection Act provisions

•In cases where patient-identifiable information is required, the PCT should, wherever possible, discuss the issue of disclosure with the individual concerned and seek consent to disclosure

By Cato Pedder

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