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PCTs may get power to fine poor GPs

PCTs could be handed greater powers for monitoring and disciplining GPs.

The Government will consult on allowing PCTs to fine GPs for misconduct and poor practice and introducing a nationwide local disciplinary process with a graded series of 'formal disciplinary warnings'.

GPs will have to copy all patient complaints to a PCT within 'a set period' with trusts responsible for maintaining a database of complaints and scrutinising it for emerging patterns.

NHS Employers will also establish a national template for a PCT-held file containing information on a GP's performance. The file will follow if a GP moves PCT and information on locum GPs will be copied to employers.

The plans are outlined in Safeguarding Patients, the Government's response to the fifth part of the Shipman Inquiry.

A GMC spokesperson said: 'We very much welcome strengthening of local practices. It will ensure that the checks we would want are taking place locally and that trusts are sharing information with us.'

But Dr Stephen Earwicker, a Nottingham GP and former PEC chair, said: 'Complaints are not usually an indicator of a bad practice. A good practice actually welcomes complaints, but a bad one discourages them. It feels like a knee-jerk reaction by the Government.'

GPC negotiator Dr Richard Vautrey said: 'One of our concerns is that the complaints procedures must be standardised. It would not be fair if some PCTs were applying tougher standards than others.'

Dr Vautrey added that GPs must have access to PCT-held files about them to ensure information was correct.

Ministers will also consult patient groups on whether patients should be notified after their GP returns from a suspension or erasure. But Dr Vautrey warned these proposals were 'unnecessarily harsh' and 'could blacken a GP's name'.

The Shipman Inquiry's proposals for a GP practice accreditation scheme, with financial incentives for reaching required standards, was rejected. Ministers argued that this would not impact on the least motivated practices, 'where defective performance is most likely to be found'.

The Government said practices would be accredited alongside acute trusts in a nationwide scheme planned for 2010. Singlehanded practices are likely to be monitored more tightly.

Proposed PCT powers

• A system of fines for GPs found guilty of misconduct or poor practice

• Maintaining a database of complaints against GPs and investigating patterns

• Holding files on each GP's performance

• Telling patients of a GP's suspension or erasure

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