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GPs are still mired in confusion over quality and outcomes visits, with practices ignoring GPC guidance to stop assessors seeing patient-identifiable data.

Many practices receiving visits last week said they had let assessors see records. Some had stuck pieces of paper on their computer screens in an effort to ensure confidentiality.

Their actions come despite GPC negotiators' warnings that GPs would be breaking the law if they did not gain full patient consent for assessors to see records and to wait for its guidance on the issue. Further problems have also emerged over visits, with at least one trust having to postpone checks because GPs could not use the essential QMAS software to total up points.

West Hull PCT postponed its first assessments until January after a practice's Vision software failed to translate its data to QMAS. 'It would be all noughts when we got there so there was no point going out,' a PCT spokesman said.

GP IT experts said the problem centred on Torex and Vision systems and meant QMAS could not extract information from GPs' records.

Dr John Williams, co-chair of the RCGP/GPC IT committee, said his practice had experienced a similar problem with its Torex software and warned there would be 'hell to pay' if it was not solved by Christmas.

'This will become a major issue if it goes on to the end of the year. This is the sort of thing we will not tolerate,' he said.

The GPC said it was still drawing up guidance on confidentiality and reiterated that GPs visited before it was released should arrange a second check, whatever PCOs said.

GPC negotiator Dr Stewart Drage said covering parts of patient notes with masking tape or bits of paper to ensure confidentiality was 'not acceptable'.

Dr Neil Crowley, a GP in Ealing, west London, said he had done just that in his visit: 'If a GP can't look at another GP's notes I don't know what we are going to do. People are just faffing around.'

Manchester LMC said it was advising GPs to ask for a second visit and to ignore trusts' demands to get consent from patients. North Manchester PCT has told practices they must get consent from 200 patients before visits.

By Cato Pedder

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