Forum Topic

Quality and Outcomes Framework - GPs

I've been likened to Victor Meldrew on more than one occasion.  A fully paid up GOG (Grumpy Old Git), and like Victor all I can say is "I don't believe it!"The local media (sorry about the use of bad language there) including this site seem to delight in such obviously flawed statistical analysis.By my reckoning, based on the performance figures in this table, we should enjoy the previously unseen site of 42 GP's walking on water at the next boat race?  Those who unbelievably? scored 95% or above.BTW perhaps the editor would like to share with us where the missing points are awarded.  When I went to school the categories listed equalled 870?Why do I care?  I'll share that with you.  At Christmas last year I suffered some minor chest pain.  My "failing" GP (I'm pretty certain she can't walk on water) was, despite the expertise of these NHS statisticians, actually good enough to diagnose my real problem.  On New Years Eve I found myself in the casualty department of the “Dreadful/dreaded” West Middlesex Hospital.  There a young “houseman” ran the necessary tests and went the extra mile to persuade the people in the scanner department to give me a scan “after hours” (at the end of their scheduled appointments).  Naturally being New Years Eve they probably wanted to be with their families, but they did their job and confirmed the suspicions of my GP and the houseman.  My condition could have been life threatening.  My treatment from my GP through casualty, a week’s stay in the WM and sixth months of subsequent treatment were all excellent.It was the much maligned local medical staff that saved my life.  Not the statisticians or bureaucrats.  In fact the only down side to my experience was entirely down to the bureaucrats whom I take to be responsible for the farce that is car parking at the West Middlesex?  Trivial complaint?  Yes.  But these are the sort of people who come up with league tables!I’m sure there are excellent Doctors amongst the 95%rs…..  But I’m equally sure there are those who know how to manipulate a return which, after all, affects their pay?  My cynicism aside, there are other slightly more significant factors to balance like the age, wealth and social circumstances of the patients.  There’s an old saying that “The only person who never made a mistake is the one who never did anything!”I really don’t see the point of publishing information like this in such a way.  If you want to make a serious point about Health Service funding, expenditure or services this information might be used (IF FULLY EXPLAINED – which you haven’t done) to support an argument.  As it stands it is pure Gutter Press.Geoff Brown

Geoff Brown ● 7244d11 Comments

""Of course performance needs monitoring, but to what end""Is it a surprise that the above statement should be made by a senior Trade Union Official!!And then to say that the publication of this performance Table is "Gutter Press" is a trifle reckless as well..in my opinion..and I'm in agreement with Anne.Remember how many million and millions of Pounds are spent on the National Health Service and the attached quango's each week ..and to suggest that surveys and monitoring are perhaps unnecessary is crazy.We want top NHS services everywhere..at all times..if possible and we need to find out all about the wastages and underperforming areas.The problems of the public not keeping GP appointments...GP's not keeping Pill reviews up to date..overprescribing pills that cost £10 each sometimes...who is going to draw attention to these things if there is no monitoring?Foreign people coming to the UK on a "Medical Holiday" to get free treatment for themselves and their extended families..whilst morally acceptable if we are helping out "another child of God" so to speak..but we don't the system being abused. Thus monitoring activity much surely be helpful ..in throwing up oddities.As Dan said " Don't shoot the messenger"..look for explanations.Isn't it crazy to read in the HM magazine that £700,000 of patient equipment..like walking sticks and zimmer frames..are not returned to the Hospital each year..just in this Area.  Having seen the GP's report published on the Chiswick and ealing websites...together with the link to the appropriate NHS webpage...I posted the original message requesting that this Brentford Forum publishes the tables too.http://www.ic.nhs.uk/services/qofI don't know how my GP did...he changes so often..and he's not been listed...and being diabetic perhaps I should be concerned.  It would be helpful to know how the St Bernards Practice did.

Jim Lawes ● 7243d

David,Indeed you've struck the nail on the head.  I worked in education in various support staff roles over a thirty year period.  As Vice President of the support staff trade union branch for many of those years I watched scheme after scheme introduced, discredited, found faulty at audit etc.  What is the REAL result of all this self congratulatory back slapping?Of course performance needs monitoring, but to what end.I was accused of insinuating that GPs were lining their pockets (which I didn't) and yet this very league table INSINUATES that my GP and her practice are failing.  Not in my case. Many of my years in education were spent on technical monitoring of processes.  Get the monitoring and maintenance wrong and the result is obvious for all to see.  This kind of scientific monitoring, just as with actual medical tests, provides vital and irrefutable results.  Performance indicators of staff performance in my experience are far from as cut and dried.  It depends on so many factors that are often beyond the staff being monitored.  Anyone taking such surveys at face value is an idiot.  They require careful analysis in the context that they were made.My experience of such surveys leads me to believe that any survey that provides a performance curve such as could be drawn from this table is basically flawed?  That aside publishing such a survey as has been done here can only falsely promote the idea that some GP's and their practices are perfect, which I strongly doubt, and others are verging on incompetent, which I'm sure is equally untrue.The concept of points for services provided smacks of the hotel star rating.  How much does the fact that a hotel has a gym, a swimming pool, a trouser press, internet connection etc. etc. really add to whether or not it is actually a pleasant and comfortable place to spend a night?  You mentioned “luck” in my case.  Sure I was lucky.  But by GP was thorough in her diagnosis to the point that my condition was established.  She spoke directly to the medical team at WM and they were expecting me and “on the case” as soon as I arrived.  Diagnosis is a fundamental skill in any fault finding, technical or medical.  You can have a workshop full of tools or a surgery full of equipment and a schedule of special clinics as long as your arm (loads of bonus points there no doubt) but without correct diagnosis you might as well have none of that.My concern, as with the stated concern of some of the GP’s, is that this is entirely misleading.  As you point out the links to detailed analysis is layers deep and even then viewed by the uniformed in isolation is pretty meaningless.  Without informed analysis and comment on the table it’s publication trivialises a complex subject to the level of a football league table.  I stand by my statement “Gutter Press”

Geoff Brown ● 7244d