GPs will have to prove quality before getting paid
By Nigel Praities
PCTs will be able to withhold pay from GPs if they cannot demonstrate the quality of their services, under plans unveiled by the Government.
Full payment on the GP contract would only be made once practices had submitted satisfactory quality accounts, which will be required from all practices by 2012.
The move will pile pressure on GPs to produce written proof of the quality of their practices, including information on patient safety, experience and outcomes.
Sir Bruce Keogh, medical director of the NHS, told the Lancet Health of the Nation Summit that the Government wanted PCTs to use quality accounts to set some ‘hard-nosed goals' for health providers.
Sir Bruce – who famously introduced mortality tables for cardiothoracic surgeons in 2004 - suggested the Department of Health would initially look at holding back 0.5% of funding until quality was proved, but that this figure could be increased.
He said: ‘You don't pay for a building until you are sure that the windows and doors are not going to fall out,' he said.
The introduction of quality accounts was a central plank of Lord Darzi's NHS Next State Review. The accounts will include a national set of information, which would be supplied to the Care Quality Commission for registration purposes, and quality metrics that GPs would need to supply to their PCT to justify their contract.
The DH confirmed it would be looking at withholding money from any GP who failed to satisfy quality account requirements.
‘We expect that a part of each quality account will be locally determined to ensure providers are able to publish information against priorities the local NHS has identified for improvement,' a spokesperson said.
Dr James Kingsland, president of the National Association of Primary Care and a GP in the Wirral, welcomed the plans as a mechanism to decommission people providing a bad service, but warned was a ‘great risk' that GPs would just end up ticking boxes.
‘What we should be doing is challenging the clinical care team so we don't make a bureaucratic system that is just paid by results and tick-boxes.
‘It cannot be top-down managed. It has to be us demonstrating our quality through our clinical skills and not collecting a load of data annually,' he said.GPs will have to prove their quality before getting paid under Government plans What are quality accounts?
All GPs will be expected to produce quality accounts from 2012, in a bid to create key quality standards for all providers.
Organisations including NICE, the Department of Health and the Care Quality Commission are drawing up guidelines to decide what quality indicators will be included.
Quality Accounts will be included under CQC registration requirements and PCT contracts.