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Gold, incentives and meh

'Scrap super-regulator'

I am writing regarding your report about Heart of Birmingham Teaching PCT's publication of QOF scores (News, June 18).

We reported QOF scores in our Board papers as we believe that an open, accountable and supportive approach offers better care for patients in our area ­ this was not a 'name and shame' exercise but a quality reporting exercise.

Indeed, it is highly regrettable that any publication should seek to stigmatise a cohort of GPs before an audience of their peers, and I can only assume that the appearance of these GPs' names on your front page was an aberration on your part.

Guidance received from Birmingham and the Black Country strategic health authority suggests performance below 750 QOF points might indicate cause for concern. At no stage have we applied sanctions against any of our practices on the grounds of a low QOF score.

Our recommendation for those scoring below this level is no sterner than a full clinical governance review, in order to provide any necessary support to help these practices address any areas that might give cause for concern.

We believe it is entirely sensible for us to refer these practices to our performance panel so we can be satisfied that patient care is not compromised in any way.

Although the performance panel has the power to impose punitive measures or refer practitioners to their professional body or legal processes, the most usual outcome would involve additional support from the PCT.

This would help practices to improve their performance in any of the seven domains contributing to their QOF scores.

Contrary to your suggestion, no practices have lost the right to 'light touch' review. This is not a privilege that can be taken away as it has not previously existed. Rather, we have rewarded practices scoring above 920 points with lighter monitoring.

It would be disappointing if practices felt our response to these QOF scores implied any threat to them.

At no stage have we threatened immediate punitive action against practices failing to achieve a given level of performance: such measures would only be a last resort and we are confident that our GPs know this.

We accept patients have the right to information about the performance of our practitioners, so we made the decision to report QOF scores to the trust board.

The Freedom of Information Act would require us to release this information in the event of any request.

Dr Vidhu Mayor

Chief Officer

Heart of Birmingham

Teaching PCT

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