PCTs across the country are investigating GPs over fraudulent reporting of their achievement results, it has been reported.
According to reports by Pulse, nine trusts have started proceedings against practices over inappropriate levels of exception reporting.
Specialist counter-fraud teams are in place to scrutinise any possible fraudulent exclusions of patients from GP figures that may be used to cook Quality and Outcomes Framework (QOF) figures.
Exception reporting allow practices to pursue the quality improvement agenda and not be penalised when, for example, patients do not attend their review or a medication cannot be prescribed because of a contraindication or side-effect.
Reports claim six trusts have already docked QOF points from GP practices whose exception reporting rates were deemed “unacceptable”.
A South West Essex PCT spokesperson told Pulse: “If a practice continued to exception report inappropriately, despite PCT advice and recommendation, and the PCT believed it to be fraudulent, it would be referred to the counter-fraud specialist.”
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Related article: QMAS appeal: do exception reporting figures add up?
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“Practices and their staff should be clear that they are working to a contract and that there are potential legal consequences of not fulfilling their obligations honestly. I sometimes have the impression that the principles involved are lost in the tick-box culture that has arisen” – Name and address withheld
“Yes, harsher penalties should be introduced for practices that cook the books” – M Santulu, City and Hackney PCT
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