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GPs who use many different locums could lose quality pay under contract

GPs in areas blighted by locum shortages could struggle to maximise earnings under the new contract's quality framework, LMCs have warned.

Regular locums familiar with practice protocols and computer systems would provide better audit data and continuity of care than those who worked for practices on an ad hoc basis, they said.

But practices in recruitment troublespots forced to rely on unfamiliar locums would struggle to hit higher targets in the quality framework's 11 clinical areas.

Dr Charles Zuckerman, medical secretary of Birmingham LMC, said: 'You have to score points to achieve payments and that's based on data input at the same time as the consultation.

'If you have a locum who knows how the computer works and how to input the data you will get more info and will be able to earn more brownie points.'

Dr Andy Stewart, chair of Cornwall and Scilly Isles LMC, said the situation was unfair for practices in remote areas. 'This will discriminate against doctors who can't find the same locum. It might be a disadvantage if a locum does not do all the necessary things for the contract even if they have done the necessary thing for the patient,' he said.

Dr Steven Carter, a GP in Sutton-on-Sea, Lincolnshire, said GPs in areas like his would be disadvantaged because it was a struggle to get a locum at all.

'Having the same locum is sensible, but it's not obvious where they are going to come from. We just want someone to keep us going.'

Dr Victoria Weekes, chair of the GPC's non-principals sub-committee, said the need to maximise rewards under the quality framework provided practices with an incentive to employ the same locum rather than having people 'zipping in and out'.

She added: 'How much chronic disease management can you do with a five-minute consultation? If you are there on an extended basis you can do more.'

From April, non-principals will have to provide a clear

audit trail for use in their

appraisals.

They will either have to have personal log-ins at their regular practices, or keep clinical diaries of patients' unmet needs, their own educational needs, referrals and prescribing histories.

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