Safeguarding

Safeguarding Patients 89
Rec Inquiry recommendation Government response
Para
Response
19 The powers of PCTs should be extended so as
to enable them to issue warnings to GPs and to
impose financial penalties on GPs in respect of
misconduct, deficient professional performance
or deficient clinical practice which falls below the
thresholds for referral to the GMC or exercise of
the PCT’s list management powers.
20 Steps should be taken to ensure that every
prescription generated by a GP can be
accurately attributed to an individual doctor. Only
then will the data resulting from the monitoring of
prescribing information constitute a reliable
clinical governance tool.
21 Regular monitoring of GPs’ prescribing should be
undertaken by PCTs. Special attention should be
paid to the prescribing of controlled drugs by
GPs. Doctors who have had a problem of drug
misuse in the past or who are suspected of
having a current problem should be subjected to
particularly close scrutiny.
21 When a restriction is placed on a doctor’s
prescribing powers, this information must be
made available (preferably by electronic means)
to those who need to know, particularly
pharmacists.
22 The Department of Health (DoH) should make
provision for a national system for monitoring GP
patient mortality rates. The system should be
supported by a well organised, consistent and
objective means of investigating those cases
where a GP’s patient mortality rates signal as
being above the norm.
23 Every GP practice should keep a death register
in which the particulars of the deaths of patients
of the practice should be recorded for use in
audit and for other purposes.
Agree in principle and will discuss
with stakeholders as part of the
broader review of the Performers
List system.
8.10 Work is already in hand to
implement this recommendation,
based on the linked
recommendation in the Inquiry’s
Fourth Report. The intention is that
every prescriber will be identified
by a unique 12-digit number which,
for GPs, would incorporate the
GP’s unique GMC reference
number while indicating the PCT
and the GP practice.
8.10 PCTs already routinely monitor
prescribing by GPs and other
prescribers. The government will
invite the RCGP to work with the
NHS Information Centre on how
such information can best be used
to assure the quality of GP
services.
Accepted – see the government
response to the Inquiry’s 4th
report, recommendation 8. For
doctors, the GMC’s web based
database of doctor’s registration
already contains details of any
restrictions on a doctor’s practice.
8.12 The NHS Information Centre has
developed and rolled out a Primary
Care Mortality Database. We will
evaluate after 12 months the
extent to which this has provided
useful information to PCTs. Early
experience suggests that practicelevel
mortality data, on its own,
may only have limited use for
clinical governance purposes.
8.13 Accept and will be take forward
with GP representatives as part of
the consultation on death
certification.