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CCGs urged to end GP ‘micromanagement’

26 November 2012

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GPs are “hopeful” clinical commissioning groups (CCGs) will “focus on what matters” and end the “micromanagement” of GP practice performance.

The Family Doctor Association (FDA) has encouraged CCGs to use the ‘two standard deviation rule’ when assessing GP surgeries’ performance.

This means looking at normal practice behaviour within “two standard deviations from the average”. The FDA claimed that it is “probable” a practice within this limit is “normal” and engaging in “reasonable” practice behaviour.

Variations from this limit should be taken as “interesting” but not as evidence of poor practice, the body said.

The guidance urged CCGs to “focus on what matters” and not “accidents of circumstance”.

“We are all on the hunt for deviants,” said FDA national chair Dr Peter Swinyard.

“It may be that one practice refers more than its neighbours in one discipline and again this should be looked at as “normal variation” rather than deviance in the first instance. GPs are in a “people business” and people”s illnesses and behaviours vary from time to time, which may cause completely inexplicable spikes in figures which are really not significant.”

The FDA argues it is “even more invidious” to rank practices, which fall within the average on their performance. For example, it claimed a practice which is 23rd in some measurement may be performing just as well as the practice which is in 2nd place, it may be just a “transient statistical anomaly”.