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Analysis: A flawed audit is no basis for altering GP pay

The idea of bundling indicators for diabetes checks in QOF is not new, but ministers have developed a sudden urgency over this after some damaging headlines in the national press.

The idea of bundling indicators for diabetes checks in QOF is not new, but ministers have developed a sudden urgency over this after some damaging headlines in the national press.

Diabetes UK has been leading a charge on GP performance on diabetes for the past few months, accusing GPs in some regions of ‘appalling' care.

A recent report from the Public Accounts Committee also said QOF was ‘failing' patients with diabetes and that it should be redrawn to only pay GPs if they carry out all nine recommended checks in patients with diabetes.

Why has this all blown up now? The answer lies in the figures being published by the National Diabetes Audit.

The most recent audit found 54.3% of people with diabetes received all the care processes recommended for the monitoring of risk factors for tissue damage in 2010/11.

However QOF results for the same year were much higher, with almost all practices across England achieving more than 95% of available points in the QOF indicators that roughly corresponded with the care processes measured by the NDA.

Admittedly they measure different things, but why is the NDA not using the QOF codes in their analysis? Why do we have such different results from two different surveys?

No-one knows the answers to these questions, and they are certainly not going to be solved with a new bundle of indicators in QOF.  A flawed survey should not be used as the basis of newspaper headlines, and certainly not for off-the-cuff policy decisions.

Sort out the audit, then we can discuss what should happen with the way GPs are paid.

Dr Bill Beeby is chair of the GPC's clinical and prescribing subcommittee

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