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End for costly PCT-run practices

Primary care trusts are giving up the running of practices after realising they cannot do the job as well as GPs.

Trusts are increasingly putt-ing their PCTMS practices out to tender because they are more expensive to run and do not provide as good a service as a GP-run surgery.

Londonwide LMCs' annual report for 2004/5 reported that PCTs in the capital were 'not advocating more development or investment in these schemes'.

The report also described PCT-run practices as having 'low-level service delivery'.

Dr Fay Wilson, secretary of seven London LMCs, said PCTs had thought running a practice would be easy, but now wanted rid of the burden.

She said: 'They have found them difficult to manage and develop. They also make the incorrect assumption that employed GPs are motivated and managed in the same way as self-employed doctors.'

Brent PCT is putting out to tender its PCTMS practices in order to attract bids under the Government's favoured alternative provider medical services (APMS) contracts.

Dr Ethie Kong, GP and chair of the trust's professional executive committee, said it wanted applications from existing GPs but said it wanted several different models of providing primary care.

She said managing services was not a core activity for the PCT. 'We are expecting both the public and private sector to come forward,' she added.

Ivan Okyere-Boakye, primary care service manager at Kensington and Chelsea PCT, said the single practice it runs will be put out for tender.

He added: 'Compared with a PMS practice it's slightly more expensive.

'It involves a lot of management time as you want it to be a shining example, but that responsibility tends to rest with senior directors and we don't have the capacity.'

GPs say PCT-run practices are also a 'recipe for disaster' ­ often scoring lower on the quality framework and providing fewer enhanced services.

Dr Hank Beerstecher, a GP in Sittingbourne, Kent, said an analysis of PCTMS practices he was conducting showed they were significantly more expensive with 'excessive poor performance'.

He said: 'PCTs will want to dump this embarrassment at the earliest opportunity.'

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