Published: 04/04/2002, Volume II2, No. 5799 Page 4 5

Doctors have been told to pull out of the new GP appraisals if primary care trusts refuse to fund them. The British Medical Association says it knows of at least two unnamed trusts which have said they will not pay for the assessments, which are due to start this month.

A spokesperson for the BMA said: 'It is quite straightforward.

Where PCTs are refusing to properly fund the system, we have told GPs not to take part. Under their terms of service, there is no requirement for them to do so.We know of a number of PCTs who say they haven't got the money to carry them out, but it is unacceptable for the burden to fall back on doctors with the workload pressures they are already facing.'

The BMA, which backs the new scheme, say the appraisals will mean a 'considerable amount' of paperwork and preparation involving around 13 hours of work for each GP. It says locums will need to be employed to cover patient care.

The NHS Alliance has already been warning the government that PCTs are facing acute financial pressures. Chair Dr Michael Dixon said each GP appraisal will cost between£600 and£700. For an average-sized PCT, the total bill will be over£50,000 a year.

'I think some will struggle, ' he said. 'It would be welcome for a central imperative to be centrally funded. PCTs are facing pressure with a host of other demands, like NICE [the National Institute for Clinical Excellence] appraisals for instance as well as the delivery of the government's targets.'

With around 30,000 GPs expected to be assessed in the coming year, last month NHS chief executive Nigel Crisp issued a strongly worded circular to all PCT chief executives reminding them of their duties.

'It is essential that you make appropriate provision for supporting appraisal in 2002-03, ' he said, adding that PCTs were 'responsible for ensuring that resources are in place'.