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'Performance indicators new blow to GPs' morale'

GP leaders have attacked new performance indicators for primary care trusts, claiming they are unrealistic and will further demoralise the profession.

The proposed indicators, published last week, will be used to decide trusts' 'star ratings'. These will then determine how much performance money and financial autonomy PCTs get from the Government.

But Dr Mike Dixon, chair of the NHS Alliance, said the indicators were 'too embryonic' for money to be attached to them and a low or no-star rating would affect GPs' morale.

He said: 'It's too early for these to be reliable or for payments to be paid. They could have a demoralising effect on the workforce.'

Among the controversial indicators drawn up by the Commission for Health Improvement and the Department of Health is for all GP principals to be appraised by April 2003.

Trusts will also be rated on whether they increase the number of women screened for breast cancer, reduce emergency admissions and ensure all out-of-hours calls are routed through NHS Direct by December 2004.

GPC negotiator Dr Laurence Buckman said trusts could not meet the appraisal target as many had not yet identified funding or appointed appraisers. 'That shows you how stupid targets are,' he said. 'Getting principals appraised by 2003 is a bone of contention for the whole of the GP world.'

He added the new breast cancer indicator may lead to GPs pressuring older women to be screened: 'We will end up attempting to make people do it who don't want to.'

The National Association of GP Co-operatives said the NHS Direct target wrongly placed responsibility on trusts for implementing the policy when funding is controlled by ministers. A spokesman said: 'Trusts would find it difficult to implement this standard unless NHS Direct told them to do so.'

Dr Tony Snell, a member of the NHS Confederation core negotiating team for the GP contract, said the indicators would have to be changed in a year's time, once data from the new contract started to emerge.

CHI said the one-month consultation period on the

indicators would establish whether the principle of informed dissent, which has been agreed for some markers ­ including cervical cytology ­ in the new contract would

carry over into the indicators.

Some of the new proposed PCT

performance indicators

 · Trusts to have plans for all out-of-hours calls to be routed through NHS Direct by 2004

 · Baseline assessment of diabetes services carried out

 · Raise number of drug users in treatment programmes

 · Increase number of people with HIV receiving highly active anti-retroviral therapy

 · Increase number of women aged 50-64 screened for breast cancer

 · Cut emergency admissions for acute ear, nose and throat infection by treating them in primary care

 · Minimum prescribing of benzodiazepines

 · Number of GPs appraised

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