GPs reject RCGP plan for practice ranking

GPs have reacted angrily to proposals for a 'practice kite mark' for every GP practice.

The RCGP has proposed that the DoH back a scheme to rank practices against three levels of accreditation, reviewed by inspection every three years.

RCGP chairman Dr Mayur Lakhani stressed that the scheme would be voluntary but conceded that primary care organisations could target practices that did not receive level-one accreditation.

He said that GPs needed to be proactive about quality standards or face more severe government inspections.

'If doctors don't do this, the government might set up something like Ofsted, and we do not want that,' he said.

GPC chairman Dr Hamish Meldrum said that the system was 'reinventing the wheel'.

'We already have a rating system - the quality and outcomes framework,' he said. 'If this idea is introduced on top of the existing quality inspections, annual appraisals and imminent revalidation for doctors, so much time will be taken up with proving quality that there will be insufficient time to treat patients.'

He added that it might be possible to include deliverable evidence-based elements of the RCGP plan in the quality framework.

Dr Lakhani said that the system would be loosely based on the RCGP's Quality Team Development (QTD) scheme and its Quality Practice Award (QPA).

The standards for levels one and two would be based on the QTD, a series of assessments looking at everything from practice opening hours to quality framework achievement.

The QPA, which has 178 accredited practices, is a more detailed assessment, including patient involvement, children's health services and minor operations.

This will be the basis for level-three accreditation.

Dr Lakhani denied that the scheme would result in a series of long and difficult inspections saying that 'this will incorporate quality visits with a single sign-off with many systems already in place'.

But GPs saw the move as unnecessary extra regulation. Leicestershire GP Dr Bill Spiegler said: 'It's a slippery slope. There are other ways to judge a practice already, like surveys and quality scores. Jobbing GPs will give it short shrift.'

The GPC said it would have preferred to be consulted before such an announcement.

Dr Meldrum admitted that the DoH could impose the system but said it would be unwise to do so.

A DoH spokesman said: 'We outlined proposals for assessing GP practices in our recent White Paper. However, this grading scheme is being drawn up by the RCGP, so talk of government involvement is premature.'

edward.davies@haynet.com.

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