Clinical commissioning groups (CCGs) should rank GPs against each other in terms of their prescribing behaviour and referral rates, a new report advises.
CCGs need to conduct in-depth comparative reviews of GP prescribing every two or three years, says the report, which is published by Dr Foster Intelligence and reminds commissioners that prescribing data by GP practice will start to be published later this year. "Commissioners will want to explore variations," it says.
The recommendations are included the firm's latest annual Intelligence Board report, which this year looks at clinical commissioning. It tells CCGs that they will need to pay attention to the overall performance of provider organisations in periodic in-depth reviews, "as these may reveal patterns and issues not otherwise obvious from contract monitoring," and that while this relates in particular to local acute trusts and providers of community services, commissioners should also be focusing on the performance of their member GP practices - "and indeed of individual GPs."
"This is one of the areas where you may well have the greatest impact," it advises commissioners.
From a commissioning point of view, the key challenge is to understand variations between GP practices and individual practitioners, particularly in their referral and prescribing habits and in the experiences and views of patients, it says. The report emphasises that the aim is not to pass judgement but to "shed light on differences and identify opportunities for learning and improvement in both quality of primary care and value for money."
"This may start of an internal process but the aim should be to gradually increase the level of transparency (and peer pressure)," says the study, which advises: "board members, both GPs and others, will need to pay close attention to engaging with GP practices and individual practitioners so as to build mutual understanding and shared objectives."
The report has been produced with the support of an independent reference group of experts chaired by Professor David Colin-Thome, former national director for primary care at the Department of Health.
"NHS commissioning has achieved less than it should have, due to a lack of clinical involvement and a dearth of high-quality information," said Prof Colin-Thome. "We should not be distracted by the fact that some aspects of the new commissioning structures and processes remain to be finalised. Commissioners need to get on and deliver results,” he added.