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Two-thirds of GP practices fail parts of traffic light ratings

By Gareth Iacobucci

Exclusive: More than two-thirds of GP practices are failing at least one element of the Government's traffic-light ratings system, a Pulse investigation reveals.

An analysis of balanced scorecards received by the first 400 practices to be assessed shows 70% received at least one red rating, with small practices and those in deprived areas most likely to struggle.

The investigation, involving detailed results from nine PCTs across the country, comes a week after the Government revealed plans for GPs to be paid by their performance on the scorecards as a way of raising standards through World-Class Commissioning.

GPs in deprived areas and smaller practices are being scored lower than their peers in larger and more affluent practices on the scorecards, which cover areas such as doctor-patient ratios, opening hours and clinical performance.

Pulse assigned practices two points for each green rating they received, one for amber and zero for red. The most deprived quarter of practices averaged 1.32 on the scale, compared with 1.63 for the most affluent quarter of practices.

Small practices averaged 1.43, compared with 1.57 for the largest.

The findings raise fears that practices in deprived areas may be forced to work under special measures, with latest Government guidance saying underperforming NHS providers should be given two chances to improve and then have their contracts cancelled.

High-scoring practices in affluent areas could also gain higher payments than their poorer counterparts through incentive schemes linked to the scorecards, although the DH guidance also allows for payments to be targeted at those that struggle.

Pulse revealed in June that NHS managers had moved to terminate the practice contracts of GPs failing to meet stringent targets, as part of an access-centred scorecard in Barking and Dagenham.

The new investigation shows that a third of practices in NHS Luton, and a quarter in NHS Hillingdon, received overall red ratings.

In NHS Camden, all 41 practices failed to meet at least one target on the scorecard, with 80% falling down on access.

Dr Una Duffy, a GP in Luton and member of Luton LMC, whose practice averaged 1.39 on Pulse's scale, said: ‘The scorecards are simplistic. A large chunk is dependent on the patient survey. Practice demographics are not taken into account – there's no weighting for ethnicity, or for patients being able to understand English.'

GPC deputy chair Dr Richard Vautrey said: ‘It's a blunt way of assessing practices. It doesn't tell the full story.'

Dr Una Duffy

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