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Exception reporting could be ditched from the next version of the quality framework because NHS managers believe it is a 'get out of jail free' card for GPs.

Dr David Jenner, GMS contract lead for the NHS Alliance, said he had been told by NHS Employers that exception reporting made the framework 'too easy' and they wanted to get rid of it.

Dr Jenner, a GP in Cullompton, Devon, said: 'Exception reporting codes are get out of jail free cards.

'The feeling I would share with you from the service ­ NHS Employers ­ is that it's too easy. You can hit targets without exception codes.'

He added: 'I predict major reform ­ they may all go.'

Other changes on the agenda include getting rid of 'holistic' points and areas of double-counting, Dr Jenner said.

Dr Peter Dickson, a member of NHS Employers' quality review team, said 'the basic principles' of the QOF had been discussed at a meeting with the GPC this week.

He refused to be drawn on the future of exception reporting, but said PCTs had not reported widespread abuse of the system in the first year.

Dr Richard Vautrey, GPC negotiator, said the principle of exception reporting was 'absolutely right', but it was only fair to allow a re-evaluation of it in the light of data collected in the past year.

Other GPs warned that tampering with the exception reporting system could undermine the entire quality framework.

Dr Charles Zuckerman, joint executive secretary of Birmingham LMC, said: 'If you abolish it GPs who have made every effort to call patients will be disadvantaged.'

By Rob Finch

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