A GP survey has found that 80 per cent of PCTs are enforcing standards beyond the requirements of the GP contract.
Over the past year PCTs have developed 'performance frameworks' involving extra standards GP must meet for fear of losing funding or their contract.
But a DoH spokeswoman told GP that health secretary Andrew Lansley was keen to move away from performance frameworks. 'We shall remove targets that have no clinical justification and move to a system of setting patient or clinical outcomes to be achieved,' she said.
GPs will 'still need to demonstrate the effectiveness and efficiency of the services they provide', she added.
Our survey of 26 PCTs reveals that 21 (81 per cent) are implementing 'performance frameworks' or planning to do so this year. Such frameworks vary, but often make extra services or hours 'core' requirements or raise QOF targets.
NHS South West Essex suggests that performance frameworks could be used to remove poorly performing practices.
NHS Havering has implemented a 'QOF+' scheme with more challenging targets. Other PCTs have created 'additional clinical indicators that all practices should aspire to achieve'.
Nick Goodwin, who is leading the King's Fund inquiry into general practice, said the tools should be standardised 'rather than having dozens of local ideas about what is an appropriate level of service'.
GPC chairman Dr Laurence Buckman said tools to improve quality need to be agreed with LMCs. PCTs threatening to remove practice contracts or changing core contracts was unacceptable, he said.
'If you have indicators and work with the LMC and practices sign up, that's okay,' he said. 'If they are imposed and practices are bullied then it is illegal. If it is not to help practices it is just a way to end contracts.'