PCTs were expected to have accredited all GPSIs in line with DoH guidance by 31 March.
But, of 90 PCTs that respon-ded to a Freedom of Information Act request, 30 per cent had not accredited all GPSIs. Of these, 13 had not even begun the process of accreditation.
Dr Brian Karet, RCGP clinical lead for diabetes and a GPSI in diabetes in West Yorkshire, said the DoH and SHAs need to increase pressure on PCTs to ensure accreditation is being carried out.
'PCTs should be accrediting all GPSIs,' he said. 'It reassures peers that people can perform the role and it reassures patients that the person they are going to is properly trained.'
Dr Sarah Gray, a GPSI in women's health in Cornwall, said that accreditation was essential for the advanced roles GPSIs undertake. 'We need to have a higher level of competence to perform a more advanced role,' she said.
'The clinical governance issues are such that GPSIs need to show they have the skills and competencies to provide a higher level service.'
But Dr Clare Gerada, vice-chairman of the RCGP, warned that even those PCTs that had carried out accreditation have done it in different ways. 'Some GPSIs are being put through on a nod, while others are required to jump through all sorts of hoops,' she said. 'Medical directors seem to be inventing their own rules to block accreditation of GPs.'
Devon GPSI Dr Brian Malcolm said that while some PCTs had introduced 'draconian' assessment measures, others had failed to have any initiative. 'I have had to bang on my PCT's door and ask: "Please can you accredit me",' he said.
Dr James Kingsland, National Association of Primary Care president, suggested that the Care Quality Commission should have a role in assessing the quality and appropriateness of GPSI services.
However, he said, if GPSI schemes were attempting to make up for shortfalls elsewhere, the quality of other services needed to be examined.
'Primary-and-a-half' care should not be introduced to make up for failings elsewhere, he added.