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PCTs given tips on how to drive down GP quality pay

PCTs have been issued with a 'top 10 tips' dossier to help them drive down GPs' quality pay, writes Christian Duffin.

The document Firm But Fair, circulated by NHS Primary Care Contracting, advises trusts to 'confirm and challenge' QOF

assessments 'at all stages'. Both low and high scorers should be 'actively targeted', it says.

PCTs are reminded they have four chances to question the

'veracity' of GPs' claims and are told to 'recognise at all times that a single QOF point equates to more than £1m nationally'.

The new approach confirms the change in attitude to monitoring GPs' performance away from the 'high trust, light touch' regime promised when the contract was signed.

Dr Barbara Hakin, lead negotiator for NHS Employers and chief executive of NHS East Midlands, said earlier this month that GPs could expect tougher checks as they were responsible for large amounts of public money. She has ordered a clampdown across her region.

Dr Laurence Buckman, GPC deputy chair, said GPs should not be scared by the threats: 'They should just make sure they are doing everything right. This will show up the idea as another attempt to besmirch GPs.'

As well as the East Midlands, Cambridgeshire, Gloucestershire, Norfolk and Suffolk have all revealed plans to shave

money from GPs' quality pay.

Meanwhile, North Essex PCT has asked GPs to defer this year's achievement payments from March until April and then withdraw from the QOF entirely for the next two years as part of a desperate effort to save money. Instead GPs would work to a local version of the QOF.

Dr Brian Balmer, secretary of Essex LMCs said: 'It is a major concern. We have no doubt that if it proved popular they would support it across the whole of the east of England. We have spoken to other LMCs and they have said not to touch it with a bargepole.'

The top 10 tips for PCTs

1 Know all the rules and the 'must dos' in terms of QOF delivery

2 Confirm and challenge at all four stages of monitoring process

3 Invest in training for QOF assessors. Important in investigating exception reporting

4 Use skills of public health colleagues and look at both high and low scorers

5 Bring in internal audit department

6 Actively target practices. Monitor practice progress through the year with QMAS

7 Scrutinise exception reporting, particularly pre-payment check

8 Use QOF assessor validation reports for confidentiality issues

9 Statement of Financial Entitlement instructs practices to comply with requests to provide data or information

10 Link QOF with PBC changes

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