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Quality framework reviews are descen-ding into chaos after the GPC warned GPs to refuse primary care trusts access to patient records or face breaking the law.

Negotiators said GPs in the first wave of visits starting this month would now have to have two reviews as the law on data protection and patient consent was still unclear.

The GPC is holding urgent talks with the NHS Confederation and Department of Health to draw up a 'legally watertight solution'.

Deputy-chair Dr Laurence Buckman said it expected to release guidance 'in the next few weeks' but GPs visited before then should omit the records check from the quality review and schedule a second visit.

But PCTs and some GPs have signalled they will defy the demand, made just two days before visits began, condemning it as 'totally and wholly unrealistic'.

Dr Nigel Watson, joint chief executive of Wessex

LMCs, said PCTs were barely able to cope with one visit and scheduling a second would be a 'mammoth task'.

A spokesman for South Cambridgeshire PCT said the trust had already agreed suitable arrangements with the LMC and the GPC advice was 'not a sensible suggestion'.

Responding to the criticism, Dr Buckman said GPs could 'show anything they like', but they would be breaking the law. He added: 'Until we have got this clear the law says you must not show patient identifiable data to anybody. We didn't expect this to be this difficult.'

Dr Buckman said assessors could look at all other areas, including organisational indicators and exception reports.

Many PCTs said they had already agreed solutions, including allowing a different doctor to inspect records and getting consent from patients visiting practices before the visit.

Amanda Muter, head of clinical governance at Norwich PCT, said it had agreed a policy after discussions with GPs.

GPs have also been advised not to use third-party software to anonymise notes as this could damage systems. But anonymisation software from EMIS and the National Programme for IT will not be available until December.

By Cato Pedder

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