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New scrutiny of GP QOF data to single out poor prescribers

GPs are facing intense scrutiny of their prescribing and disease prevalence data in a new bid by managers to single out poor performers or excessive prescribers.

An NHS unit has circulated reports to 30 PCTs analysing 'how practices are performing against QOF outcomes and against each other'.

The confidential reports combine QOF prevalence and PACT data to rank GPs and identify those with high or low use of drugs linked to different quality indicators.

The body responsible for prescribing across the NHS said such analysis would be used 'more and more' ­ suggesting it will prove a template for wider reviews of GP performance.

PCTs said they would use the reports to flag up areas requiring 'further investigation'. But the GPC condemned the plans as illogical micromanagement.

Dr Heath Heatlie, who prepared the reports on behalf of 30 PCTs covering thousands of GPs in the West Midlands, said: 'The analysis offers a new insight into how GP practices prescribe and how they are performing against the QOF and each other.'

Dr Heatlie, research fellow at the department of medicines management, Keele University, added: 'It will help pharmaceutical advisers and QOF leads to go to practices and ask why their prescribing was very low or high compared with similar practices.'

PCTs are currently deciding how to use the reports.

Alison Tennant, pharmaceutical specialist in public health at Dudley Beacon and Castle PCT, said: 'The report definitely won't be ignored. We will use it to flag up areas that need further investigation.'

Smethwick PCT said the reports were 'really useful' and gave 'clear ideas of where GPs are in relation to other PCTs'.

But at least one PCT has refused to use its report for fear of aggravating GPs. Dr David Jeffery, QOF lead for Herefordshire PCT, told Pulse: 'We decided not to pursue it. We didn't think it was particularly useful and could be confrontational.'

GP leaders criticised the prescribing analysis.

Dr Grant Ingrams, secretary of West Midlands Regional LMC, said: 'It's rarely robust enough to be used as a management tool.'

Dr Laurence Buckman, GPC deputy chair, said: 'To use it as yet another micromanagement tool by people who don't understand what micromanagement is all about is illogical.'

But Dr Neal Maskrey, medical director of the National Prescribing Centre, said: 'This is not the first example I have seen of QOF data being linked to prescribing data. The approach is interesting ­ and one we will see employed more and more.'

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