Practices in Birmingham with high quality scores for cervical screening are being told that they are in breach of contract because their scores do not meet national targets.
Heart of Birmingham PCT is targeting 34 of its 78 practices that achieved less than 75 per cent cervical cytology coverage in women aged 25 to 64.
But under the quality framework, GPs are rewarded up to 11 points for ensuring 40-80 per cent of women have had a smear test within the previous five years.
A spokeswoman for Heart of Birmingham PCT said the 'rigorous approach' was helping to identify more women for screening in the area and was helping the PCT achieve the national target of 80 per cent.
The trust has an average uptake of 77.7 per cent across its practices, and the lowest reported uptake was 59 per cent.
'The trust has written to them (practices achieving 75 per cent or less) alerting them that this may be a clinical governance issue which needs to be resolved, and requested that robust action plans are put in place to achieve improvement,' added the spokeswoman.
Birmingham LMC is disputing the issue, claiming the policy breaches performance management regulations.
Birmingham LMC medical secretary Dr Charles Zuckerman said practices had received threatening letters warning them to improve.
'These are practices hitting the top of the quality framework target, being told they must be failing to provide proper clinical governance,' he said.
The LMC will support any practice that is issued with a remedial notice, said Dr Zuckerman, and urged GPs to stand up to what he described as 'bullying tactics'.
GPC negotiator Dr Chaand Nagpaul said the policy was 'strange and unusual', and that there were many good reasons why certain areas might not achieve an 80 per cent uptake.
'It is a rather extreme and simplistic approach,' he said. 'It is not helpful or facilitative to a problem that might be down to mobile populations or cultural differences. It is certainly not a contractual requirement.'
The PCT has recently come under criticism for its plans to move 78 practices into 24 franchised premises.
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