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PCTs rush to implement GP ‘scorecards’

By Gareth Iacobucci

PCTs are already rushing to implement a controversial ‘schoolcard' system for rating GP performance, ahead of Government moves to persuade managers to use it across the country.

An exclusive Pulse survey shows many trusts are developing their own balanced scorecard systems – which rate practices from A to C on a range of parameters – with some starting to publish results on their websites.

Last week Pulse reported that the Government was ‘committed to implementing' balance scorecards following recommendations in a report by primary care tsar Professor David Colin-Thome.

Our survey found a third of trusts were already publishing figures online, with the RCGP calling moves to place GPs in league tables ‘completely inappropriate'.

Dr Colin-Thome's report had suggested PCTs should commission scorecards and publish ratings on trust websites – leading to concerns that the balance scorecard system could become a simplistic exercise in naming and shaming.

Out of the 23 trusts contacted in a snapshot survey, two thirds already had some sort of balanced scorecard scheme up and running, although only a third of these were publishing details, often as part of ongoing performance reports.

A further 17% of trusts said they were currently developing balanced scorecards, which are based on a system initially piloted last year by Tower Hamlets PCT.

In the pilots practices were rated annually against 19 indicators including access, A&E visits and clinical and cost-effectiveness of prescribing.

GPC negotiator Dr Chaand Nagpaul branded balanced scorecard systems as ‘unnecessary' and ‘crude', and warned publishing results would lead to them being misinterpreted.

‘Crude data does not explain individual circumstances, and does not address the fact many practices' so-called performance is more a result of being under-funded, he said. ‘It's an unnecessary step, which could be demotivating to GPs.'

Dr Nagpaul added that balanced scorecard systems were unnecessary given the raft of existing measures used to measure performance.

He said: ‘This is the wrong way to proceed. We're going to see practices judged on different criteria, depending on which PCT they reside in. It should be done at national level and not at a local level where you will get assessment by postcode.'

Professor Steve Field, Chair of the RCGP, which is developing its own system of practice accreditation said: ‘Where general practice is concerned, we are totally against the use of any system that might lead to a league-table system, as this would be entirely inappropriate.'

Key findings

- 82% of PCTs either have or are developing versions of the balanced scorecard system
- 65% of trusts have a form of balanced scorecard up and running
- 33% of those that already have balanced scorecard systems in place are publishing the findings, often as part of on-going performance reports.

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