CCGs must monitor GP referral and prescribing performance

Clinical commissioning groups (CCGs) should monitor both member practices and individual GPs' referral and prescribing behaviour, according to a report.

Professor Colin-Thomé: 'NHS commissioning has achieved less than it should have due to a lack of clinical involvement and a dearth of high quality information'.
Professor Colin-Thomé: 'NHS commissioning has achieved less than it should have due to a lack of clinical involvement and a dearth of high quality information'.

A report from The Intelligent Board, a Dr Foster initiative, said that CCGs should be focusing on 'the performance of their member GP practices, and indeed of individual GPs'.
 
In particular it is important for CCGs to understand the any variations between the referral and prescribing habits of GPs, the report said.

'The key challenge is to understand variations between GP practices and individual practitioners, particularly in their referral and prescribing habits and in the experiences and views of patients,' the report said.

Initially comparisons between referral and prescribing behaviour could be made within practices, but eventually GPs practices could be ranked against each other.

The comparisons 'may start off as an internal process but the aim should be to gradually increase the level of transparency (and peer pressure),' the report said.

In order to monitor performance, the report suggested that CCGs carry out 'in-depth quality reviews' of GPs practices every two or three years.

The focus of these reviews should be a 'comparative analysis' of indicators such variations in referral rates for GPs,' the report said.

In his foreword to the report, former primary care czar Professor David Colin-Thomé said: 'NHS commissioning has achieved less than it should have due to a lack of clinical involvement and a dearth of high quality information.'

GPC negotiator Dr Richard Vautrey said that making any comparisons between GP referral and prescribing behaviour should be done with ‘great care’.

‘Referral and prescribing behaviour is very complex. Someone may refer in a different way for a very good reason,’ he said.

Dr Vautrey said that it is important not to assume that someone who is a low prescriber is necessary a ‘good GP’.

Making such an assumption could be ‘misleading and lead to the wrong conclusions,’ Dr Vautrey warned.

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