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At the heart of general practice since 1960

Is it right to challenge ARB approach?

The first detailed, official picture of GPs' quality achievement in the first year of the GMS contract emerged this week, with publication of Scotland's quality scores.

The results confirm GPs have made a spectacular success of their first stab at the quality framework, with GMS practices scoring an average of 971.3 points and non-GMS practices 903.9.

GPs were delighted with their scores, but warned there had already been murmurings from the Government that the framework was too easy.

The GPC insisted practices had worked 'bloody hard' and asked whether officials would have preferred GPs to provide substandard care.

GMS practices in Scotland earned an average of £76,400 from the quality framework and non-GMS ones £64,750.

Scores varied substantially between clinical areas, from hypothyroidism with 99 per cent of points available down to COPD with 88 per cent and epilepsy with 86 per cent.

GPs found points in organisational domains slightly harder to hit than clinical points, but still managed 89 per cent of those available.

Prevalence data released simultaneously was generally slightly lower than the Welsh data released last month, but slightly higher for CHD.

Dr Bob Liddell, former chair of Grampian LMC and a GP in Turriff, said the first year of the framework had gone 'phenomenally well'.

But he said GPs were worried about comments from the Government about value for money. 'Some officials suspect that it may have been too easy for us but that's not the case; I think people worked extremely hard to achieve it.'

Dr Brian Keighley, a GP in Balfron, member of Forth Valley LMC and UK GPC treasurer, said some elements of the press had used the data 'inappropriately' in league tables. 'I don't think anyone went into the quality exercise thinking they were going to have their name plastered over the Scottish papers,' he said.

GPC chair Dr Hamish Meldrum warned that PCTs might have to ask the Department of Health for extra funding if the results were replicated across the UK.

But he added: 'Practices and their teams have worked bloody hard. We never suggested they would only achieve 75 per cent. Would the Government rather a system where only 50 per cent of patients got a good service?'

Buddy scheme lands 'the full monty' of 1,050 points

Dr Stephen Dunn used teamwork and a buddy scheme with a neighbouring practice to achieve 'the full monty' of 1,050 points in the quality framework.

Dr Dunn, a GP in Dumbarton, Argyle and Clyde, held special clinics for diabetes, asthma and COPD and employed locums to free up time for work on the framework.

The key, he said, was teamwork: 'We worked very strongly together and every member of staff was motivated and informed about where we wanted to get to. We're delighted to get the full monty.'

Dr Dunn and his two partners also twinned up with another local practice, which also achieved 1,050 points.

'It was motivational and encouraged openness as well as competition,' he said.

The practice has already received its reward ­ a payment of £59,000.

By Nerys Hairon

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