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CAMHS won't see you now

'Another nail in the coffin' for commissioning

Changes to the Payment by Results tariff have hammered 'another nail in the coffin' for practice-based commissioning, GPs believe.

A new tariff released this week halves centrally-funded 'top-up' payments meant to help PCTs that lost out due to the introduction of Payment by Results. GPs said cuts to the 'purchaser parity adjustment' scheme will send many PCTs further into deficit and mean more pressure on doctors not to refer or prescribe.

Dr Charles Zuckerman, joint chief executive of Birmingham LMC, said local trusts would lose millions of pounds.

He said: 'Hospitals are going to be under extreme pressure not to admit patients and to discharge them and GPs not to refer or prescribe.'

Dr Grant Ingrams, West Midlands regional LMC secretary, said Coventry Teaching PCT faced a shortfall of £13 million for one year as a result of the implementation of Payment by Results. He said: 'The pressure will come on practice-based commissioning. It's another nail in the coffin.'

Nicola Easey, commissioning lead for the NHS Alliance, said PCTs knew the adjustment scheme would end in 2008, but had no warning that earlier cuts would be made to funding.

She said: 'There's certainly a risk there will be fewer services and PCTs and practice-based commissioners need to look carefully at commissioning decisions next year, especially in places expected to produce a surplus.'

The purchase parity adjustment scheme aimed to protect trusts whose commissioning costs rose starkly as a result of Payment by Results.

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