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Independents' Day

DH slams brakes on 'traffic light' ratings plan after GP opposition

Exclusive: The Department of Health has shelved plans to develop a traffic light ratings system for general practice after GP leaders raised concerns that the scheme would be unworkable, Pulse has learned.

After consulting on plans to develop a ‘traffic light’ rating system that could have seen practices given a red, green or amber rating for a whole swathe of data, the DH decided the scheme would be unwise given the current strain on general practice and the risk that it could lead to GPs playing the system and simply referring more, Pulse understands.

The move was part of Jeremy Hunt’s ‘transparency agenda’ which has already seen him announce proposals to ‘name and shame’ GPs who fail to refer enough cancer cases by publishing a ‘red rating’ on the NHS Choices website.

And in July the DH announced that it was working up plans for a new website – which will be separate to the existing NHS Choices website - to compare GP practices against one another to drive up standards. This followed reports in the Mail on Sunday that the DH site could include ‘traffic light’ ratings for practices, which would see patients with more elderly patients admitted to hospital given a red rating.

However talks with GP bodies had highlighted concerns that the scheme could disadvantage GPs in deprived areas, or lead to GPs playing the system and simply referring more, sources told Pulse. While the DH had also acknowledged that GP ratings weren’t directly comparable to other parts of the NHS – for example the recent publication of surgeons’ mortality data for surgeons, they said.

Where data on surgeon’s mortality rates looked at a specific, regularly repeated task, this couldn’t be translated to the complex conditions and social factors GPs routinely manage, they said.

Both sources said that they expected wider drives towards publishing data about general practice in future, and said GPs should involve themselves in the discussion of how this is developed.

Dr Richard Vautrey, deputy chair of the GPC, said although he hadn’t been told about the DH rowing back on plans for GP ratings, he said the GPC had had discussions about the scheme, highlighting the ‘significant flaws’ that implementing such a system would entail.

He told Pulse: ‘I do know that the department has been listening to the concerns of GPC and others about the significant flaws in the system that would occur if they tried to do this.’

‘We’ve been highlighting the complexity and the diverse outcomes and the way that this would misrepresent what practices do, and wouldn’t be helpful to patients making an informed decision, in any way.’

‘So I think they have heard that, and I would hope that they are thinking again about what an ill-thought through proposal this would be.’

The Department of Health was approached for comment, but had not responded at time of publication.

This story was edited on 21 August to clarify that the Mail on Sunday, rather than the Daily Mail, initially reported the plans to traffic light GPs.

Readers' comments (12)

  • At last the message appears to be sinking in before every GP sinks

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  • Let's hope they have genuinely shelved this ridiculous plan. Going forwards, would it be too much to ask that someone in DOH engages their brain and considers the knock on effects with such stupid schemes BEFORE opening their mouth?

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  • I object to the derogatory "playing the system" comment - did that really come from the DoH? GPs are not "playing" - we are trying to do the best we can to care for our patients with limited resources and in the face of unnecessary external pressures such as this

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  • Peter Swinyard

    Crude ratings are totally unacceptable. How can you expect a GP and their practice funded at £60 per patient per year to offer the same care as one funded at £120 per patient per year - these disparities exist across the country.
    Practices which are locked into inadequate premises and struggling with high demand can never perform as well as those in less unfavourable circumstances no matter how hard their doctors and staff work.
    By all means publish data - but publish all data and in context so we don't end up with silly ratings tables. After all, the top 1-2% probably are exceptional, the bottom 5% may need looking at but there is no practical difference between a practice rated 15/100 and one rated 80/100 apart from the risk that the latter will be demoralised.
    One also wonders why this agenda and why now?

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  • "I object to the derogatory "playing the system" comment" @ 10:55

    Maybe not the most charming wording, but it was exactly the point we GPs ourselves were making when the proposal were announced: Name & shame us for missing cancer diagnoses and we will refer more patients. Name and shame us for letting more elderly be admitted, we will fail to admit seriously ill patients.

    Whether you call it "playing the system", "gaming" or "perverse incentives", it is exactly what the problem with these schemes would be.

    I am just glad that the DoH has acknowledged the problem, whatever wording they use.

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  • I seriously doubt this is the end to rating system. Our "leaders" would be too naive to think it will not go any further too.

    Surgeons objected to mortality data for the same reason (playing the game by lowering the threshold on refusal to operate on those that may die) yet they were forced through. DoH has much less respect for primary care then secondary care so whatever makes anyone think they'll shelf this idea for good, I don't know.

    Best we can hope for is a few months delay - before it gets imposed in the contract for next year perhaps?

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  • i very much doubt that this has been shelved//it will reappear after the elections-whichever party wins

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  • once things go pear shaped i will be happy to name and shame those politicians and NHS quango's responsible :)

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  • Do you seriously believe this has been shelved because politicians saw sense and realised this was impractical/ill thought out or because they have been warned costs via increased referrals will skyrocket?
    I suspect it's the latter. Which inevitably means a newer version of this hairbrained scheme is in the pipeline

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  • Harry Longman

    Naming and shaming politicians and their failed policies would be so much simpler, cheaper, faster to implement and more effective. For starters:
    HSCA re-organisation
    Choose and Book
    48 hour target
    Advanced Access
    (please continue...)

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