Editorial: Over-monitoring GPs doesn't benefit patients

GPs will be relieved to finally discover more detail on how revalidation will work.

Until now, most doctors have been in the dark about how much effort it will entail.

Initial signs are that it will be less onerous than feared. It is more flexible and less complex than earlier pilots, the RCGP says.

This is potentially good news, but it does not detract from the fact that general practice is about to enter a new era of regulation and scrutiny, of which revalidation is just one part. GPs, particularly those in England, are now facing a barrage of new assessments.

Most PCTs have started developing balanced scorecards; with some already using them to rate practices. Then, from 2012, English practices will be legally required to register with the newly-formed Care Quality Commission (CQC).

The extent of conditions attached to this registration is unknown. However, last week the CQC indicated it may not be averse to interfering with GP clinical decision-making when it said PCTs should 'performance manage' GPs' statin prescribing.

It doesn't end there. Patients' views must also be considered: there is the widely discredited patient survey which informs QOF payment and England's NHS Choices looks set to extend its controversial online patient-rating service to practices shortly.

At this rate, GPs will be spending a significant amount of time proving they and their surgery are 'fit to practise' - time they previously could have spent seeing patients.

Of course GPs should work to a high standard and be able to demonstrate this, and patient feedback is important, but there is such a thing as too much regulation.

Looking at the list of assessments to which GPs will be subjected, there is clearly some duplication. This hardly represents good value for money for the taxpayer. One also has to question whether all these additional checks will really improve patient care.

Yes, appraisal and revalidation provide a way of assessing the quality of individual doctors, but GPs already have a system to demonstrate that their practice provides a good level of care - it is called the QOF.


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