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Quality bar to be raised...

GP pay is set to be tied to adherence to NICE guidelines in the next draft of the quality and outcomes framework, Pulse has learned.

NICE believes it has secured an agreement from ministers to incorporate guidance into future quality indicators.

NICE sees improving implementation of its guidelines as a key priority and is keen to use the contract as a tool to force up uptake.

But GP representatives said any move to pay GPs for their adherence to NICE would prompt a 'backlash'. They warned the workload implications would be enormous.

A NICE spokesperson told Pulse: 'We understand the GP contract will start to cover the implementation of NICE guidance. We have said to the department this would be another way to monitor the implementation of NICE guidelines and link it to outcomes.'

She strongly denied the inclusion of NICE guidelines in the quality framework would amount to a 'crackdown'.

NICE said it was advising the Department of Health's quality framework team on ways that 'aspects of NICE guidance' could be included. It is submitting evidence on guidelines developed since the framework was drawn up, in areas such as COPD, diabetes, CHD and heart failure.

NICE also hailed a 'college' of four PCTs in Bristol, north Somerset and south Gloucestershire as a model for 'proactive' implementation.

One of the trusts, Bristol North PCT, is planning to pay practices £1,000 each to audit adherence to NICE and draw up action plans to improve uptake. The trust has also analysed GP prescribing of methylphenidate and found 'continued reluctance to take on the responsibility'.

GPs remain suspicious of any link between pay and adherence to NICE. Dr Robert Morley, executive secretary of Birmingham LMC and a GP in the city, said: 'The workload implications are enormous. The quality framework is bad enough but if GPs see the goalposts raised again there could be a backlash.'

Dr John Pittard, a board member of the Primary Care Cardiovascular Society and a GP in Staines, Middlesex, said it would be 'unwelcome' in some clinical areas.

By Nerys Hairon

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