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Only 1% 'gaming'

The great majority of practices have used exception reporting appropriately but around 1 per cent may be guilty of 'gaming', the first national analysis of the system reveals.

Preliminary findings from the National Primary Care Research and Development Centre show the overall level of exception reporting was 'very low' at just 5.4 per cent.

The figures, obtained by Pulse, indicate that rates varied between clinical areas, from 7.3 per cent for COPD down to just 0.6 per cent for hypertension (see box).

But the researchers estimated 80 to 200 practices had suspicious levels of exception reporting that warranted scrutiny.

Study leader Dr Tim Doran, public health research fellow at the centre, said: 'It's certainly true there are practices that are gaming. The numbers seem to be quite small.

'Perhaps 1 per cent of practices have rates we might question ­ I wouldn't have thought it's much more than 200.'

But he added: 'Some of the early estimates around exception reporting did suggest reports were going to be really very high. For [the indicators analysed] the exception reporting has been very low ­ in the region of 5 to 6 per cent.'

Dr Doran acknowledged that exception reporting levels could be higher for individual indicators. A Pulse analysis last December found exception report levels of around 10 per cent for target indicators in diabetes and mental health.

Dr Adrian Jacobs, member of NHS Employers' core negotiating team and director of primary care at Torbay Care Trust, said: 'I know of people who were feeling GPs were abusing exception reporting ­ the data does not support that.'

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