GPs warned on honesty of claims

GP practices have been warned to take care when making claims under the Quality and Outcomes Framework given the current row over MPs’ expenses claims.

The Medical and Dental Defence Union of Scotland said a GP was struck off the General Medical Council’s register in January for falsifying QoF claims and warned other GPs to be scrupulously honest.

The medical defence body said that while MPs may currently be in the firing line it was aware of cases when GPs had fallen foul of employers or regulators over inappropriate or ill-informed fee claims.

Dr George Fernie, head of the medical defence organisation’s medical division, said QoF payments were the main potential pitfall for patients alongside claims for temporary residents.

He added: “While most GPs are scrupulously honest, in the current economic circumstances, some may be tempted to boost income with claims that surf the line between the creative and the fraudulent. We strongly urge them to resist. The GMC has firm views – and rightly so – on GP probity.”

The MDDUS said it had cases on its files GPs failing to look closely enough at whether ‘temporary’ patients should be registered and that it was also aware of a tiny minority of practice principals conspiring to “massage” QOF points.

It said speculative claims could be picked up by the NHS Counter Fraud Service, random QoF reviews or payment verification visits.

The defence union said the GMC’s Good Medical Practice states that being honest and acting with integrity is integral to medical professionalism.

The guidance states that as a GP, “you must make sure that your conduct… justifies your patients’ trust in you and the public’s trust in the profession."

Dr Fernie added: “If in doubt, ask yourself: would my actions withstand public scrutiny?"