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Practices face PCO challenge on quality pay

By Ian Cameron and Craig Kenny

GPs face a clampdown on their quality aspiration pay

after the NHS Confederation accused practices of submitting unrealistic bids to 'pump prime' their income.

The threat emerged after a Pulse snapshot survey of 31 PCOs found in some areas

almost every practice had

aspired to all 1,050 points and submissions were routinely over 900.

The results are far ahead of GPC predictions that practices will achieve 750 points on average. Negotiators said last week they doubted whether many of the practices predicting high achievement would be able to do it.

Ministers have also only allocated enough money to pay for across-the-board achievement of 770 points.

The NHS Confederation said it believed some GPs had put in high bids to maximise their cash-flow.

A spokesman said: 'There is some concern practices are using the aspiration payments as a means of pump-priming. We expect practices to be realistic and for PCOs to emphasise this.'

Newham PCT in east London said it would challenge some of its practices that aspired to maximum points.

'I don't think that's a realistic aspiration given our practice population,' said Jenny Mazarelo, director of primary care planning and development at the trust. Checks would focus on organisational markers, she added.

PCOs can invoke the

contract's dispute resolution procedure to force practices

to lower their bid if they

do not believe a practice's explanation of how they will achieve it.

North Eastern Derbyshire PCT said it believed some practices' aspiration levels were unreasonable and it 'would be discussing more appropriate levels' with GPs.

Bedford PCT said it was challenging one-fifth of its practices.

GP negotiator Dr Laurence Buckman said GPs who had done little work to set up systems for the quality framework were 'kidding themselves' if they thought they could achieve 900 points.

He said: 'It's really quite hard and you might argue they are being over ambitious.'

The contract warns that GPs whose achievement is far below their aspiration are more likely to face checks from NHS fraud-busters.

GPs aspire high on quality

Average quality point aspiration levels in 31 PCOs


Brighton and Hove City, Carlisle and District, Eden Valley, Salford, West Cumbria


Airedale, Bath and North East Somerset, Central Manchester, Chorley and South Ribble, Derbyshire Dales and South Derbyshire, Lambeth, Newham, North Manchester, Sussex Downs and Weald, Bristol South and West, Borders, Dumfries and Galloway


Bedford, Broxtowe and Hucknall, Cheltenham and Tewkesbury, Cheshire West, Craven Harrogate and Rural District, Hastings and St Leonards, North Eastern Derbyshire, North and East Cornwall, North Tees, Rochdale, Shropshire County, Yorkshire Wolds and Coast


Canterbury and Coastal, Central Suffolk

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