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GP contracts should be rewritten to boost PBC, says NHS Alliance

By Nigel Praities

GPs should have their contracts rewritten to incentivise them to work with specialists, pharmacists and nurses to commission services, the NHS Alliance says.

The strategy to revitalise practice-based commissioning calls for ‘local clinical partnerships' where GPs and other healthcare professionals are given direct budgets to commission local services.

It says PBC is currently not fit for purpose and recommends a ‘renewal' of GMS and PMS contracts with ‘capitated and risk-adjusted budgets' for local health services.

‘With PBC apparently unfit for purpose in its present form, and PCT commissioning frequently cautious and tentative, further thought is urgently needed as to how to boost commissioning,' the report says.

‘A local clinical partnership is a means of bringing together the known benefits of involving clinicians in NHS resource management, with an incentive structure that could engage them in local service redesign aimed at improving the quality of care, and securing greater efficiency of service provision.'

The proposals – written in conjunction with the Nuffield Trust – are similar to plans revealed by the National Association of Primary Care last week but offer much more detail.

NHS Alliance Dr Michael Dixon said the plans were an ‘elegant solution' to prevent PCTs becoming more conservative about devolving their responsibility in the current downturn.

‘[This] will lead to far faster devolvement of services and health initiatives to the locality wherever possible - re-design that we keep talking about but which hardly ever seems to happen,' he said.

NHS Alliance chair Dr Michael Dixon NHS Alliance chair Dr Michael Dixon

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