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Study prompts call for higher flu vaccine uptake in under-65s

10 months on from the new contract, and with quality visits now completed, Nerys Hairon asks how things are going

Teething problems on visits

Central Manchester PCT

Up from zero stars to one star

Population 185,000

Number of GPs/practices 105/41

Average practice Q&O target 800-900 points

Prescribing overspend 2003/4? No ­ break even

% of practices in PMS 34%

% of GMS practices needing MPIG 70%

GPs in Central Manchester have faced 'significant teething problems' over quality visits and frustrations over IT systems.

Manchester LMC secretary Dr Peter Fink said the trust had left GPs waiting ' a ridiculous amount of time' for their visits.

He said GPs' attempts to work out their quality scores had been dogged by problems with the trust's single server IT system. Initial estimates suggest they are on target for 750 to 800 points.

Professional executive committee chair Dr Ivan Benett, who took part in the quality visits, said the trust had tried to make the process as 'developmental as possible'.

He said Central Manchester PCT had not released guidance on exception reporting and that many GPs seemed 'reluctant' to do it. 'We will evaluate how the visits have gone and how other PCTs responded,' added Dr Benett, a GP in the city.

Enhanced services commissioned by the trust last year are set to continue in April. But the LMC said premises funding was still a source of frustration.

Confidentiality stumbling block

Coventry Teaching PCT

Remained on two stars at the last review

Population 330,000

Number of GPs/practices 170/63

Average practice Q&O target 800-1,000 points

Prescribing overspend 2003/4? Yes ­ figure being revised down from initial estimate of £1.8 million

Practices in PMS 50%

GMS practices needing MPIG 100%

Coventry PCT faced a major headache over confidentiality during its quality visits

and has been unable to

verify GPs' quality achievements.

'We have had a big problem,' admitted Peter Hodder, director of primary care for Coventry PCT.

'We have had to work within what we have got and before we verify the quality framework we're going

to have to get over the problem.'

But despite the difficulties, Mr Hodder said the visits had been a success and the trust was 'very impressed' with GPs' achievements. 'Most practices have made progress towards their targets,' he said.

The PCT regards the time since the contract as a 'year of exploration'. It admitted it was still grappling with prescribing pressures, but GPs, pharmacists and prescribing advisers were working to cut waste.

The PCT is extending its enhanced services for a further three months while it undertakes a review and is considering a nationally enhanced service for sexual health.

GPs exceed quality predictions

S. Cambridgeshire PCT

Down from three stars to two

Population 103,000

Number of GPs/practices 64/17

Average practice Q&O target 850 points

Prescribing overspend 2003/4? Not significantly over

% of practices in PMS 41%

% of GMS practices needing MPIG 100%

GPs in South Cambridgeshire are on target for an average quality score of over 900 points after a successful programme of quality visits.

Some practices look set to exceed their own aspirations, the trust believes.

South Cambridgeshire PCT prepared for the visits with pilots and set up a GP panel to sort out parameters for exception reporting.

'The practices are generally achieving aspiration targets or overachieving,' said Clare Morris, assistant director of primary care.

Ms Morris said the quality framework had put prescribing bills under pressure, but it hadn't been as bad as the trust had feared.

'We're always trying to get our prescribing budget down and the framework has had an impact. But we have quite good levels of generic prescribing,' she said.

The trust plans to commission locally enhanced services to 'compensate' for areas of care not met by the contract.

'There is a question whether a nationally agreed contract best meets our local needs,' said Ms Morris.

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