GPs will have to prove they follow NICE guidelines or face the possibility of suspension, prosecution or the closure of their practice, the Government's new health and social care regulator has warned.

Baroness Young, chair of the Care Quality Commission, revealed that guidance from NICE would become legally enforceable from 2009/10, with doctors to face tough annual checks on their compliance.

Pulse has also learned that the commission is determined to bring all GPs under its remit, having told the Government the 'significant clinical risks' justify 'system regulation of primary care as well as professional regulation of individuals'.

Baroness Young told last week's NICE annual conference in Manchester that policing clinical guidance was set to be a key part of the CQC's work, and admitted the commission had been handed 'draconian' powers by ministers.

'We want to raise the profile and highlight the importance of NICE guidance and build this into the new registration scheme,' she said.

Baroness Young added: 'I have an image of a patient sat in front of their GP or consultant with a card with the NICE guidance so they can interrogate their healthcare provider.'

A CQC spokesperson said: 'We expect providers always to comply with NICE guidelines and other national guidance unless they can show a good reason to vary from them.'

GPs reacted angrily to the proposals, arguing there were often good clinical reasons not to follow NICE guidelines.

Dr Alun Cooper, a GPSI in osteoporosis in Crawley, West Sussex, and chair of the National Osteoporosis Society's primary care forum, claimed recent NICE guidance on osteoporosis was in direct opposition to clinical opinion.

'We are going to be heavily policed and I don't have a problem with that if the NICE guidance is sensible. But here we are with the extreme example of guidance that took six years to develop and is completely unworkable,' he said.

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