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Step-by-step points for clinical targets

GPs will be paid a proportion of quality cash for partial achievement of clinical indicator targets.

The maximum number of points will be awarded for full achievement, but a linear proportion will be awarded for partial success starting from a 25 per cent minimum.

For example, a maximum seven points is available for vaccinating at least 85 per cent of CHD patients in the previous flu campaign. A practice achieving 55 per cent uptake would earn 3.5 points.

The clinical indicators for each area are split into three types ­ structure, process and outcome. To score points for process and outcome a practice must first have achieved the structure indicator.

The organisational domain, additional services domain and patient experience domain will be based on a yes/no tick box.

The quality framework has a safety-net to prevent GPs being penalised if patients refuse to consent to treatment. Exception reporting will cover:

·any patient who has refused to attend for review despite three invitations

·newly diagnosed and newly registered patients

·patients for whom the standard is not clinically appropriate or the medication cannot be tolerated

·patients for whom informed dissent is recorded

·patients whose outcome remains sub-optimal despite maximal tolerated doses of medication.

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