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Out-of-hours monitoring “should be encouraged”, says Alliance

The NHS Alliance has lent its support to On Call Care, theKent-based out-of-hours service provider recently reported to haveintroduced performance monitoring of its GPs.

While performancemonitoring has been criticised in some quarters - for increasingpressure on GPs to cut back on the number of referrals they make tosave money, for instance - the independent primary care body arguesthat it has value in letting doctors know what their colleagues aredoing in similar circumstances.

The Alliance says that "what isuseful in in-hours practice is equally important for out-of-hoursservices", and that comparing the numbers of referrals for commonconditions, prescribing decisions and home visits is an importantcomponent in ensuring high-quality care.

The Alliance says:"Sometimes doctors do not make home visits when they should, or fail torefer when a referral would ideally be indicated. At the same time,unnecessary referrals and medication can be as damaging to patient careas the opposite."

NHS Alliance chairman Dr Michael Dixon said:"I've experienced this sort of monitoring myself, so I know howuncomfortable it can feel at first.

"But what I and mycolleagues quickly learnt is that it is one of the most constructiveways for doctors to develop their own practice. It should be encouraged- not criticised or feared."

"Providing monitoring is based ondoctors sharing their clinical decisions with other doctors - notnonclinical staff interfering with clinical decisions - it can help allof us improve the care we give our patients. Thankfully, the days ofclinical isolation are long past."

NHS Alliance

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