GPs on 600 points face PCT takeover

By Nick Bostock, 06 October 2006

GP practices in England could be put out to tender if they scored fewer than 600 points in the second year of the quality framework, according to senior NHS officials. The threshold could rise as high as 800 points for 2006/7. The remarks follow the publication of 2005/6 quality framework scores for England and Northern Ireland last week. Practices in England scored 1,011 points on average, worth £125,360 to the average practice. Practices in Northern Ireland scored the highest of any UK country, with an average of 1,028. Nine practices in England scored fewer than 400 points, 29 scored fewer than 600 points and 179 practices scored fewer than 800 points. Over 800 practices in England scored the maximum 1,050 points. The lowest PCT average score was for Bradford City, where practices averaged 910 points. This was still higher than practices in the Orkneys and Highlands of Scotland, which averaged less than 900 points. Chris Town, chief executive of the newly established Cambridge City and South Cambridgeshire PCT, said that if practices scored fewer than 600 points they could be replaced by private firms. ‘If a practice does not improve despite the PCT working with it, we would deal with it through the performance route,' Mr Town said. ‘That may mean ultimately the practice going out to tender. Under 600 points may be worthy of that course of action.' He said that the threshold could rise to 800 points next year. Health economist Professor Alan Maynard, of York University, said low-scoring practices could be replaced in the next 12 months. ‘In the medium term, practices will be put out to tender and the private sector will come in. That is certainly the DoH's intention. It could happen in the next year,' he said. DoH clinical director of primary care contracting Dr Mo Dewji said practices scoring less than 600 points should ‘ring alarm bells'. He said quality scores should not be looked at in isolation, but meant ‘increased likelihood of low scores in other areas'. Asked if the DoH backed replacing practices with poor quality scores, a spokesman said: ‘Where a PCT has reason to believe a practice is performing poorly, it will intervene to support the practice as it sees fit.' However, GPC negotiator Dr Richard Vautrey said: ‘PCTs should not introduce arbitrary cut-offs to carry out local witch-hunts.' The quality framework was only ‘one part of the jigsaw' and was voluntary, he pointed out. ‘There is no guarantee private firms could do better in difficult areas. PCT-run practices have not done well,' he added.