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'Underclass of salaried GPs as pay gap splits profession'

The Department of Health is pushing for quality targets

for identifying and treating chronic kidney disease in the next draft of the framework.

The department has submitted evidence on the need for GP targets to the quality review panel as part of its drive to implement the new national service framework on renal disease. A strategy document released this week also outlines plans for closer scrutiny of renal care, with the Healthcare Commission set to develop new performance indicators on diagnosis and treatment.

But GPs have warned that extra resources and specially trained nurses would be needed to meet quality targets.

Professor Mike Kirby, a GP in Letchworth, Hertfordshire, and an associate member of the British Association of Urological Surgeons, said: 'It will require a lot more funding.

'There are going to be very large numbers of patients, particularly as you would be screening all patients with hypertension. It would be a 15- to 20-minute appointment with a nurse for each patient annually.'

Professor Kirby, who is professor in health and human sciences at the University of Hertfordshire, added: 'I think these things are laudable. We would need input from specially trained nurses doing protocol-driven clinics.'

Renal NSF standards that could

become GP quality targets

·Routine screening of hypertensive patients for CKD

·Identification and assessment of people at increased risk of developing CKD

·Management of BP, cardiovascular risk and disease and urinary tract problems

·Collaboration with specialists and community staff over palliative care

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