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At the heart of general practice since 1960

NICE should listen to GPs, not dictate

NICE last week released research suggesting it has had 'little discernible impact' on primary care. So it intends to get tough, expecting future versions of the quality framework to toe its lines and inspectorates to factor NICE adherence into their ratings. The GP nightmare of performance league tables looms.

This is all rather different from the NICE launched just five years ago to provide helpful guidance for doctors, without

seeking to usurp their clinical judgment. Like the Q&O itself, NICE feels less 'voluntary arrangement' and more 'set of rules' by the day. But while the Q&O at least offers GPs a carrot for their obedience, NICE seems to be brandishing a stick.

GPs will need reassurance that they are not to be penalised for exercising their clinical judgment against NICE guidance.

And they need guidelines that make sense

in the complex setting of primary care. It's time NICE listened to GPs, rather than telling them what to do.

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