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Gold, incentives and meh

Pay GPs for work on sexual health, advisers demand

The number of GPs being investigated for poor performance has jumped by 50 per cent and will hit a record level next year.

Latest figures from the National Clinical Assessment Authority (NCAA) show 317 doctors, 145 of them GPs, were referred in the first five months of this financial year.

The authority said it expected 750 doctors to be

referred by the end of

March 2005, up from 524 in 2003/4.

The proportion of GPs

being investigated has also

increased from one-third to

almost half of reported cases.

However, the NCAA and GPs welcomed the figures as evidence that PCOs were tackling poor performance early rather than resorting to disciplinary measures.

A spokeswoman for the NCAA said the rise in referrals was due to increasing awareness among PCOs and hospital trusts of its role. She added that the proportion of GPs being referred would even out as PCOs 'bed down'.

GPC negotiator Dr Laurence Buckman said 'the principle of recognising that people need help' was good. 'Better that than the GMC or police getting involved,' he said.

GMC referrals fell in the first year after the NCAA was set up, from 4,504 in 2001 to 3,937 in 2002, and remained constant the following year.

Dr Emma Sedgwick, med-icolegal adviser at the Medical Defence Union, said it was too early to say if greater use of the NCAA would lead to a reduction in GMC referrals, but added the authority was trying to 'stop problems developing into a crisis'.

GMC member Dr Brian Keighley, a GP near Glasgow, said the authority contributed to the ethos of clinical governance in the NHS, which was designed to 'stop dysfunction before it becomes serious'.

One in eight referrals to the NCAA is considered serious enough to be sent to the GMC.

Since the authority was set up in April 2001 it has ordered 57 full assessments of a doctor's ability, including 25 GPs.

Previous figures have shown male GPs in their late 50s are far more likely to be referred than female or younger doctors.

The NCAA takes referrals from PCO and hospital trust managers, not patients.

By Cato Pedder

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