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Royal college is forced to retreat on star rating system for GP clinics

London Madeleine Brettingham

The Royal College of General Practitioners announced last week that it was suspending talks with the Department of Health after an outcry over an article in The Times (6 Jun, p 1) that claimed that the college was planning to introduce a star rating system for general practices.

The chairman of the college, Mayur Lakhani, said: “In light of the recent feedback we have had and the anxieties that GPs feel, I have today decided to review the project and suspend discussions with the Department of Health.”

Professor Lakhani expressed dismay that the leaks—which claimed that ratings allocated by an expert panel would be displayed outside surgeries on a plaque—made the proposals appear punitive.

Hamish Meldrum, chairman of the BMA’s General Practitioners Committee, welcomed the college’s retreat, saying that the measures were counterproductive and that many doctors felt they had not been consulted.

The Times article described the system as similar to the UK’s Corgi rating for plumbers and said it aimed to ensure that the United Kingdom’s 42 000 GPs were performing suitably for their average salary of £94 000 (€137 000; $173 000).

Professor Lakhani said there would now be a period of consultation to ensure that the scheme—amounting to a rolling out of the college’s current voluntary quality initiatives—would not be “misused.”

“It is potentially a good way of improving patient care, and it’s done internationally, but it mustn’t be done for punishment. It would be a problem if the Department of Health pursued a scheme without the engagement of the profession. But I think that’s unlikely,” he said.

His comments were made at a meeting held at the college to discuss the future of the GP’s role. GPs expressed a desire to have more influence on their local council’s housing and education budgets and better access to diagnosis equipment to shorten waiting times.

Professor Lakhani added that he was keen to explore the potential of alternative medicine—in contrast to the Royal Society, which recently hit out at a report, backed by Prince Charles, that recommended increasing funding of such treatments in the NHS.

“I think where there is [positive] evidence—for example, with things like acupuncture—then it should be looked into,” he said. “And actually it is very popular with patients. It’s something I would support, if there is evidence to show that it works.”

Helen Lester, a professor of primary care at the University of Birmingham and a Birmingham GP who specialises in mental health, said: “I think calls to ban complementary medicine are very short sighted. There is a perception that it is only middle class, Guardian reading women who are interested, but this is not the case.”

She said, “I have done a study with severely schizophrenic patients and found that many of them were interested in alternative medicine [BMJ 2005;330:1122]. There is an emerging body of work to show that it works.”

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Relevant Article

Patients' and health professionals' views on primary care for people with serious mental illness: focus group study

Helen Lester, Jonathan Q Tritter, and Helen Sorohan
BMJ 2005 330: 1122. [Abstract] [Full Text] [PDF]