Two GPs were suspended for 12 months in May after an MPTS tribunal found that their falsification of QOF records amounted to serious misconduct.
The tribunal accepted that their motivation was not financial gain but a bid to save their practice from being closed down by the CQC.
Dr Syed Imam and Dr Tariq Aziz Siddiqui, who were previously GP partners at the Cleveland Surgery, backdated a number of QOF records between 2018 and 2019 which amounted to over £44,000 of income.
The practice was put in special measures by the CQC in January 2018 after being rated as ‘inadequate’, which was in part due to their low QOF scores.
They had achieved 65% of the total number of points available, compared with CCG and national averages of 94% and 96% respectively.
Another CQC inspection later that year showed improved QOF scores and led to an upgraded rating of good.
However, concerns were raised by staff about the validity of these QOF records, and local investigations found that the partners had been backdating QOF data in patient records, with 85% of reviews for cancer care patients having been falsified in 2017/2018.
At their tribunal, both doctors admitted to their wrongdoing and showed ‘genuine remorse and regret’.
Part of their evidence showed that a neighbouring practice had recently closed meaning 5,000 patients were displaced to Cleveland Surgery.
The tribunal chair Mr Nathan Moxon said: ‘The surgery was under pressure to perform and, as GP partner, Dr Imam had the responsibility for those displaced patients.
‘In turn, this pressure caused Dr Imam to be stressed and concerned that repeated failures would lead to the CQC closing his surgery too, leaving thousands of patients without adequate care. Dr Imam stated that this led to his actions to falsify the QOF entries.’
While the tribunal determined the behaviour had been dishonest, leading to an impairment of their fitness to practise and suspension, it was satisfied that their actions ‘did not put patient safety at risk’.
It also acknowledged that the GP partners did not act in the interests of financial gain, rather to improve their CQC rating and save the practice from closure.
However, Mr Moxon said: ‘The dishonesty was serious as it was premeditated, repeated, prolonged and designed to mislead regulators to avoid appropriate regulatory scrutiny.’
During the tribunal, both GPs had evidence of ‘unblemished’ records and several positive testimonials on their character.
The GP partners were treated separately in the hearing, however the evidence heard and assessment of the tribunal were very similar.
A review hearing will take place for both doctors before the end of the period of suspension.
Earlier this month, following a MPTS suspension decision, Pulse revealed that the GMC admitted it was wrong to suggest to the tribunal that the doctor’s apology to a patient was an admission of guilt.
so in the end, whose really to blame?
It sounds very much like they ‘put the interests of their patients above those of themselves’, as the GMC instructs us to do in the guidance ‘Good Medical Practice’.
Clearly, what the CQC should have done on the first occasion, was to ensure that they were given extra resources to manage the extra patients that the CCG had dumped on them……….?
instead, the CQC threatened to withdraw care from thousands of innocent patients, and 2 doctors tried to avoid this…..?
Whilst the dishonesty here is not acceptable the vicious circle some practices are in with demands exceeding capacity to just cope yet alone tick qof boxes is made worse by the cqc inspections and labels perhaps. Well resourced practices are able to employ staff to help manage qof data (and cqc tick boxes) This practice had another closed one ”dumped upon them”.from what one reads. What would be interesting would be to know if the low qof score resulted in increased mortality/morbidity. A better solution would have been for the ccg to have given the resource to the practice on the first inspection…..
The advent of PCNs and PCN targets will make the situation worse as it is in the case of PCNs led by financial gain for Clinical Directors and a few others in large groups but definitely not in the interests of General Practice as a whole or patients
Unfortunately, greed takes over. I don’t buy into this argument of under sourced Practice being unable to do QoF so it’s condonable to cheat. QoF is not mandatory. If you can’t do it, then don’t. There’s no need to cheat – let’s face it, there is monetary interest involved and that brands this kind of behaviour as corruption. I’ve seen Practices that in the month of January have to only 43 percent QoF but end up miraculously with 97 percent. How do they do it. It’s not one underfunded Practice, it’s a percentage – hopefully, a very small one, that comes in this category. Having said that, you have to have a malicious CCG/ICB that would compel you to do something that is not mandatory and even report you to CQC who we know to be plain bullies. Do they have a right to blacklist a Practice for not doing something they don’t have to. Maybe in the mentioned cases, there were issues involved of which we have no idea.