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PMS GPs plan own versions of the quality framework

PMS GPs are starting negotiations on making radical alterations to the GMS quality and outcomes framework to suit their practices.

The practices are planning to ditch elements of the framework, including areas they say are not evidence-based, and replace them with markers such as care for the homeless, depression and mental health problems.

PMS practices have been guaranteed an equal share of the quality money on offer from the new GMS contract and the Government has given them power to negotiate a

'local variation' of the framework to tailor it to their needs.

The move has angered the GPC which insisted the framework should not be subject to local variation.

Dr Sam Everington, a PMS GP in east London, said he would push for a quality framework which would account for the fact certain targets, such as smear tests and diabetes care, were harder for his practice to achieve because it is in a deprived area.

'We have a very high pick-up rate so what we are doing

is good, but if all you do

is base it on the outcome then it doesn't look as good,' he said.

Dr Graham Archard, a PMS GP in Christchurch, Dorset, said he was planning talks with his trust about 'getting rid of some of the anomalies that are not evidence-based'.

Stroke patients with normal cholesterol levels would not need a cholesterol check every year and there was no evidence checks for thyroid function for all patients had to be done every year, he added.

Dr Raj Aggarwal, a second-wave PMS GP in Pontefract, Yorkshire, said many evidence-based interventions were not in the quality framework. 'There is some evidence for depression, in that interventions in primary care can have an impact,' he added.

GPC negotiator Dr Peter Holden said the quality framework was 'ruthlessly peer-

reviewed and evidence-based'.

He added: 'A PMS doctor is free to adapt anything they like but what they can't do is call it the GMS framework and take GMS money.'

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