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Health scares are making a misery of GPs' working lives

There has been much said recently about the workload implications of the quality and outcomes framework. A major problem for clinicians is the requirement that specific Read codes are used to qualify 'work done' for QOF points.

I have always considered this to be the wrong way round and a serious flaw which I would have expected the negotiators to have resolved.

The correct process is for the clinician to decide the most appropriate code to attach to any diagnosis or event (such as a blood pressure, peak flow reading). It is for the designers of QMAS then to ensure that all relevant codes for whatever clinical activity they wish to examine are trapped by the QMAS software.

The present arrangement is typical of the 'cart before the horse' approach that we have seen and continue to see in most, if not all, aspects of the application of the new contract and the NPfIT. No wonder those at the grass roots find the resulting mess both tedious and frustrating.

I put this argument quite firmly to those responsible as soon as the 'approved list' of Read codes was released about two years ago. It was ignored.

The purpose of clinical coding is to allow clinicians to analyse their data for the benefit of patient care and for their own education. If managers need this data for other purposes, provided confidentiality is observed, they may use it in an appropriate form. But please don't put the cart before the horse.

Dr Michael Blackmore



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