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PCTs move to close under-fire singlehanders

PCTs are implementing policies aimed at cutting the number of singlehanded practices, as a new Healthcare Commission report questioned their performance in the QOF.

A Pulse investigation has found at least three PCTs across London – in Islington, Barking and Dagenham and Southwark - have a formal policy to phase out single-handed practises.

Seven more are reviewing their policies on singlehanders in light of Lord Darzi's controversial push to merge prac-tices into polyclinics.

A spokesperson for Isling-ton PCT said: ‘The trust has a longstanding policy of not replacing single-handed practices with another single-handed practice. This is because we believe modern general practice is best delivered by groups of GPs working together in premises that meet minimum standards.'

Havering PCT is one of many actively encouraging singlehanders to join bigger practises. A spokesperson described small practices as ‘potentially unsustainable'.

News of a renewed drive to reduce numbers of singlehanders came the week the Healthcare Commission's State of Healthcare report warned: ‘GP practices in deprived areas and particularly sole practitioners performed relatively less well on the QOF.'

It found these practices had higher admissions for myocardial infarction and lower rates for planned angina and coronary artery bypass grafts, adding: ‘These indications may be indicative of unmet need'.

But Dr Peter Swinyard, a GP in Swindon and honorary secretary of the Family Doctors Association, said: ‘Patient satisfaction is consistently higher. How do we convince PCTs that small practice is not bad practice?'

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