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Softly-softly on annual Q&O visits

Government-commissioned guidance is urging PCTs to take a softy-softly approach to the annual quality framework review visits to avoid alienating edgy GPs.

PCTs should let some fraud slip through the net rather than risk damaging provocation, the report said.

The advice, drawn up for the Department of Health by the University of Sheffield's School of Health and Related Research, came as a relief to GPs who were concerned that the review visits would undermine the high-trust ethos of the new contract.

The report cited two senior interviewees who said: 'The initial focus should be on building confidence rather than a belt-and-braces approach to verification.

'The damage done by losing trust and provoking irritation would be greater than

the damage done by fraud.'

The report raised the shortage of suitable GPs to join PCT review teams, saying that an average PCT with 25 practices would create a workload equivalent to 0.17 of a full-time GP. And it suggested there might be some occasions where it was unnecessary or impossible to include a doctor on the PCT assessing team.

Dr Andrew Dearden, GPC negotiator and Cardiff GP, said it was vital to have a doctor on the assessing team or it would result in a 'slightly lopsided view'. But he said: 'This is a common-sense paper. Let's hope it's implemented with the same degree of


Dr Ruban Prasad, GPC member and a GP in Preston, said: 'It will take a lot of goodwill on both sides for the contract to be properly bedded in.'

How quality framework visits will work:

lVisits should take one day or less

lVisits should be scheduled between October and January with problems addressed by March deadline

lGPs to submit written evidence one month in advance

lPCT Q&O team should trawl information and identify a selective list of items for discussion

lEach practice should nominate a Q&O lead and a Q&O team

lNo binding veto for either practices or PCTs on members of the other's team

After the event:

lPCTs to draw up a report of likely achievement within two weeks, to be sent to GPs for comment

lRoutine verification checks to be carried out before achievement payments can be made

lDisputes should be resolved locally if at all possible and by the end of June at the latest

lFive per cent of GPs will be subject to random fraud checks

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