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Tighter rules likely as exception reporting rises

GPs are set to come under renewed pressure over exception reporting after new figures showed increased use of the system in the latest year of the quality framework.

The rate of exception reporting in England increased to 5.9% last year, up from 5.6% in the previous year, figures from the Information Centre show.

Publication of the statistics – which show particularly high rates of exception reporting for the newer indicators introduced in 2006 – follows release of similar statistics for Scotland, Wales and Northern Ireland reported last month.

All clinical domains except asthma, cancer and hyperthyroidism had a higher rate of exception reporting than the previous year. The largest increase was in mental health, where new indicators for bipolar disorder, schizophrenia and other psychotic illnesses were added in 2006 – up from 5.4% to 14.6%.

Chronic kidney disease, also controversially introduced last year, had a rate of 14.3% overall and the highest rate for any indicator, 29.7%, for CKD03 – the percentage of patients with a blood pressure reading of 140/85 mmHg or less.

The new figures are set to provide ministers with the evidence they are looking for to tighten the rules on the use of exception reporting.

But Dr Timothy Scott, a GP in Tibshelf, Derbyshire, said responsibility for any exception reporting clampdown should lie with PCTs, not the Government. ‘The PCTs are acting as the agents of the Department of Health in this case and are the most appropriate people to check that GPs are not exception reporting inappropriately.'

Exception reporting

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