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Referrals for suspected RA 'too slow'

Public health experts are claiming the new GMS contract will do nothing to tackle fundamental inequalities in health care after two new studies highlighted deep divisions in the management of cardiovascular disease.

Cardiovascular risk factors were significantly under-assessed in south Asian and female patients, concluded an analysis of 75,000 patients in Stockport, Cheshire.

The researchers concluded: 'These findings present evidence of bias in recording of CVD risk factors by gender and ethnicity.'

Women and the elderly were also less likely to receive treatment for heart failure than other patients, according to a separate survey of 53 practices in Scotland, published in Heart (September).

Professor Deborah Baker, lead author on the Stockport study, said the quality framework would merely push up GPs' recording of risk factors and do nothing to iron out inequalities in care, which could be caused by 'misconceptions' about patients from different cultures.

Professor Baker, chair in public health at the University of Salford, said: 'We don't have any evidence to say that recording in GP practices is as good

as that recorded centrally.

All the evidence says it's worse.'

Her results, covering patients aged 35-60 who took part in a local screening programme, were presented to the Society for Social Medicine annual conference earlier this month.

Dr Nick Summerton, a GP in Goole, East Yorkshire, and a reader in public health and primary care at the University of Hull, said: 'In many ways the contract has been a step backwards and that's sad. It's levelling everyone down rather than levelling them up.'

Bristol GP Dr Peter Brin-dle, Wellcome Health Services Research Fellow at the University of Bristol, said under the contract 'it doesn't matter who you record'.

He added: 'There are all sorts of reasons why recording between ethnic groups might differ. Language is one thing, but there are also cultural differences.'

By Rob Finch

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