Practices in Tower Hamlets in east London will be ranked A, B or C on indicators that in some cases go beyond the requirements of their contract.
A spokesman for Tower Hamlets PCT last week confirmed that practices would need to offer extended hours to receive an A-rating for access — a priority area for the scorecard.
The guidelines for the balanced scorecard, set to be implemented next month, allow for C-banded practices to be served remedial notices as a last resort.
Critics fear that a C-banded practice will be vulnerable to takeover by an alternative provider.
Practices with open-but-full lists would be banded C, early guidance states.
There has been a ‘great deal of interest’ in the scorecard from other PCTs, the Tower Hamlets spokesman said, adding that the DoH had shown an interest.
GPs in the West Midlands, where the scorecard is due to be introduced from September, have protested to their SHA that it is unfair, biased and will impose an unacceptable extra workload.
Dr Stewart Drage, a GPC negotiator, said that PCT officials in Liverpool were ‘playing with the idea’ and he was concerned ‘about a domino effect’.
Asked whether scores would be published, Dr Drage said: ‘Not if I can help it.’ But he admitted: ‘It has been talked about, and we are concerned it might happen.’
West Midlands LMCs’ chairman Dr Simon Parkinson said: ‘It is fundamentally unfair to have a system of grading that will be published where B-scoring practices are fully compliant with their contracts.
‘This is potentially going to be used as a lever to get us.’
In Tower Hamlets, practices are expected to initiate an action plan if more than one in 100 of their patients uses the local walk-in centre.
Dr Philip Bennett-Richards, vice-chairman of Tower Hamlets LMC, said the LMC was still in discussions with the PCT about the scorecard.
‘As an LMC we support the PCT’s thrust to improve services in general practice.
‘However, we have reservations about whether the balanced scorecard will achieve those aims and are extremely conscious that it may be used as a summative tool and not as a formative one,’ he said.
‘We have been encouraged by the dialogue and feel we have had an input into collaboratively changing some of the finer points of detail,’ he added.