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Gold, incentives and meh

New quality check revives threat of GP league tables

League tables of practices are back on the agenda under Government plans for increased scrutiny of the quality of service offered by GPs, Pulse has learned.

The Department of Health is in talks with the Healthcare Commission on developing an assessment regime for all practices and other primary care providers.

The regime, which is likely to see one in five practices inspected by the commission every year, could see practices issued with kite-marks for demonstrating high-quality services. But poorer providers would be 'held to account'.

The plans were mentioned in the Our Health, Our Care, Our Say White Paper. It said there were 'no recognised schemes of assesmment for the provision of services in the community'.

Gary Needle, head of the Healthcare Commission's improvement programme, said talks with the department were at an early stage, but it hoped to adopt a similar approach to its inspections of PCTs.

Trusts make an annual declaration about compliance with core standards and a proportion are inspected each year. The commission then produces a detailed report.

Mr Needle said the information on practices had to make sense to patients and enable them to 'exercise choice'. He added the assessment could also be used to rank practices.

He said: 'It would be wrong to say there are no circumstances in which a league table could emerge.'

GPs argued it was almost impossible to produce tables that accurately reflected differing practice circumstances.

Dr Paul Cundy, GPC member and a GP in south London, said: 'I don't think a league table based on a practice's output will have any value whatsoever unless there's at least an assessment of the input into that practice.'

One option under consideration is for the RCGP's Quality Team Development scheme to underpin the accreditation regime. Dr Mayur Lakhani, chair of the RCGP, said it would press for this as any assessment system had to be robust.

He said: 'We don't want untried and untested schemes, particularly those that don't engage clinicians.'

Dr Richard Vautrey, GPC negotiator, said information provided to patients had to be set in a proper context. 'Whatever is being proposed must not impose a huge bureaucracy on small practices that much larger organisations would be able to cope with relatively easily.'

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