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Practices with low quality scores could lose livelihood to private firms

GPs could have their contracts ended and practices taken over by private firms if they do not score well on the quality framework, writes Ian Cameron.

A leading Department of Health official said last week that PCTs should use quality scores to judge whether practices are providing 'acceptable' standards of care.

Dr Mo Dewji, head of primary care contracting at the department, said below-average scores, year-on-year falls or even below-average rises in quality points could all be cause for PCT concern.

Ministers have already given PCTs the green light to replace 'underperforming' practices with private firms on alternative primary medical services (APMS) contracts ­ and left it to trusts to decide how they judge practices.

Dr Dewji said the number of points achieved was one means of assessing performance and should be considered alongside a practice's workload and other factors.

'If a practice decides it wants to participate in the framework and the level of quality is very poor compared to neighbouring practices or if there was a decline, there would certainly be concern. If every practice improved by

7 per cent but you are out of sync it may raise questions.'

PCTs should try to support practices when problems were identified, Dr Dewji added.

But GPs criticised the use of quality scores for performance assessment, arguing participation in the framework was voluntary and low achievement did not mean poor performance.

GPC deputy chair Dr Laurence Buckman said using quality scores was only acceptable if it was not the 'exclusive or major part' of an assessment: 'If the quality framework were the sole judge it would be very disturbing.'

Dr Charles Simenoff, executive member of Manchester LMC, said PCTs would face the wrath of the profession unless they acted sensibly.

'If I decided I didn't want to get quality points does that make me an underperforming practice? It's up to PCTs. If they decide to get heavy there may be an even greater shortage of GPs.'

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