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PCTs rethink balanced scorecards as Lansley revolution takes hold

By Ian Quinn

Exclusive: A controversial traffic-light rating system for practices is being torn up by PCTs across England, following health secretary Andrew Lansley's move to hand GPs local decision-making powers.

In as many as half of trusts where balanced scorecards have been introduced, GP leaders have already forced an overhaul, after the scheme was rendered largely redundant by the removal of access indicators and introduction of new clinical benchmarks.

Pulse has learned NHS London has already agreed to replace the current system with a more ‘developmental' option, following input from LMCs and the RCGP, with many other trusts following suit.

Dr Michelle Drage, chief executive of Londonwide LMCs, said balanced scorecards topped a list of unpopular performance-management weapons, favoured under the previous government.

She said: ‘Balanced scorecards are not fit for purpose. We will make sure in future they are developmental, not about punishing GPs and imposing targets. It goes completely against what the Government has said it wants to do.'

Of 35 trusts with balanced scorecards that responded to a Pulse survey, 17 said they were already reviewing or planned to review their remit.

NHS Leeds said it would be removing access targets in line with the revised operating framework, while NHS East Lancashire said it would be ‘reviewing inclusion of access targets'.

NHS Hammersmith and Fulham, one of a number of PCTs that has given practices red ratings for high A&E attendances, said: ‘We are increasingly using the scorecard to support the development of practices.'

Other trusts were more hard line, with NHS Dudley saying it would be ploughing ahead with performance management of GPs despite Mr Lansley's intervention: ‘None of the scheduled initiatives including performance management are being put on hold until there is a specific formal directive from the Department of Health.'

NHS Coventry said: ‘We believe scorecards will become even more important with the focus on quality and safety.'

Nearly half of trusts have rolled out scorecards with a further 40% saying they planned to do so in 2010/11.

But GPC negotiator Dr Chaand Nagpaul said: ‘Balanced scorecards should be scrapped. GPs must be free to commission without being hamstrung by political diktat.'

Dr Chaand Nagpaul: 'Balanced scorecards should be scrapped' Dr Chaand Nagpaul: 'Balanced scorecards should be scrapped'