Plan to publish GP performance data revealed by government

GP performance data are to be published as part of a DoH transparency drive, the government revealed this morning.

The GPC said the government would have to work closely with the profession to make sure it brings real benefits to patients.

GPC chairman Dr Laurence Buckman said greater transparency could drive up clinical standards but that publishing data without details of local populations 'would make it impossible for people to interpret the information appropriately'.

'Measuring health outcomes is a very complex area and so the government will need to work closely with the profession to ensure that it actually brings benefit to patients and the NHS,' he said.

Speaking at a Cabinet Office briefing in London today, Professor Bruce Keogh, the DoH's medical director, said he would work with the RCGP to discuss how publication would work and what data would be used in a process described as 'GP-led'.

Data on outcomes of cardiac surgery patients have been published for over 10 years. Professor David Taggart of the department of cardiothoracic surgery at John Radcliffe Hospital, Oxford, and professor of cardiovascular surgery at Oxford University, told GP that despite initial scepticism, cardiac surgeons now supported the publication of data on outcomes.

'Providing this kind of data had driven up the overall quality of care,' he said.

As well as improving outcomes, publication had also helped to drive down costs of providing services, he said.

Dr Buckman said many factors, including comorbidities and availability of support services, could affect health outcomes. 'Any national audit would have to be sufficiently sophisticated to take this into account, otherwise we could end up with simplistic league tables which, without context, could mislead the public,' he added.

Dr Buckman said: 'Publishing GP practices’ prescribing data without the context of the demographic of the population would make it impossible for people to interpret the information appropriately. Similarly, comparing the clinical outcomes of GP practices would need to be done in a way that is fair and compares like with like – rates and outcomes for chronic bronchitis, for example, can differ markedly depending on the lifestyle and even the occupations of the local population.'

Professor Taggart said experience of publishing cardiac surgery outcomes had shown that data had to be adjusted for patient risk factors to be meaningful and useful.

'When you're publishing data it must be risk-adjusted,' he said. 'To make it fair, it must be risk-adjusted to take away patient-related factors.'

Professor Taggart said that, in assessing outcomes of long-term conditions, consideration would need to be taken of what the most appropriate measures to publish would be. 'You have to try to define the important quality markers that you'll be measuring,' he said.

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