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MMR pressure builds on GPs

GPs are to come under renewed pressure from primary care trusts to convince parents of the safety of MMR after uptake of the vaccine was made a star ratings indicator.

The move came in an overhaul of PCT performance indicators for 2004 that saw 10 new categories, including MMR uptake, set by the Commission for Health Improvement.

The final targets to rate trusts on the percentage of two-year-olds who have had MMR will be set by the Department of Health early this year.

MMR uptake was included in 2001/2 performance indicators for primary care groups but not in the first round of star ratings for PCTs last year. Trusts face extra pressure to meet performance targets this year as managers of zero-starred PCTs could be replaced by private sector hit squads.

The decision to include an MMR indicator has split opinion with some GPs arguing it is 'ridiculous' for the Government to expect public opinion to be affected by PCTs' involvement. Others warned incentivising trusts to improve uptake would harden parents' scepticism about the motives behind GPs' defence of the vaccine.

GPC Wales chair Dr Andrew Dearden said the Government's response to the MMR crisis had been 'pitiable' and it was now trying to blame trusts as well as GPs for plummeting uptake.

He said: 'I'm not sure what PCTs are going to be able to do other than put more pressure on GPs.'

But fellow negotiator, GPC joint-deputy chair Dr Simon Fradd, said trusts would now back GPs in an 'aggressive' campaign to spell out the dangers of not having the jab. 'Up to now we've been reluctant to spell out the consequences,' he said.

'There's a need for us to get much more on the offensive with parents and be much more aggressive in why we believe in MMR.

'Rather than having an esoteric discussion about research, what they understand would be to say 10 children could die in their area if there's an epidemic.'

Dr Mike Fitzpatrick, north London GP and MMR expert, said including a target in PCT star ratings would have no impact on uptake levels.

He added: 'The idea that PCTs chasing it will impact on uptake is ridiculous.

'It really depends on the level of public concern around the issue. That is the key factor, it has nothing to do with PCT indicators.'

Dr Ashwin Shah, professional executive committee co-chair of Newham PCT, where uptake is below 80 per cent, said a hard core of patients were against MMR but trusts would now be more aggressive in trying to sway opinion.

New star ratings indicators for PCTs

 · Drug misuse: treatment

 · Child and adolescent mental health services

 · Child protection

 · Diabetic retinopathy screening

 · Health equity audit

 · Immunisation: MMR

 · Infant health

 · PCT commissioning of NHS Plan deliverables

 · Six-month inpatient waits

 · Workforce datasets: data quality on ethnic group

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