League tables of GPs' heart failure performance planned
By Nigel Praities
GPs face increased scrutiny of their management of heart failure, including league tables of their performance, under new recommendations for the NHS.
Guidance from the NHS Institute for Innovation and Improvement aims to reduce ‘inefficiency and variation' in heart failure services.
But the document's controversial proposal that GPs should be ranked by their rates of admission and readmission for heart failure has been criticised as time-consuming and potentially dangerous by GP experts.
The recommendations come from the second phase of the High Volume Care Programme, which claims to have been highly successful at reducing bed-days and admission rates for mental health and emergency care. It has now been extended to a range of further conditions including heart failure and diabetes.
The guidance on heart failure services also advises that GPs regularly review their registers to ensure patients have the right diagnosis and that a system is set up to compare heart failure services at different GP practices.
Sarbjit Purewal, an associate from the NHS Institute, said: ‘What this report aims to do is share best practice so that the standard of care offered is the same no matter where you are.'
Dr Ahmet Fuat, a cardiology GPSI in Darlington who runs a specialist heart failure clinic, said many of the report's recommendations were sensible but that league tables of individual GP performance would be hard to produce and an unreliable measure of performance.
‘It is dangerous to have a league table broken down in this way. Our admission rates were extremely high last year, but they were pushed up due to one 39-year-old with extremely severe heart failure who was in and out of hospital 20 times,' he said.
Dr Fuat also said hospital coding was often wrong, with a third of heart failure admissions in his area actually the result of other conditions.League tables of GPs' heart failure performance planned