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Many to miss PBC milestone

A key milestone in the implementation of practice-based commissioning looks set to be missed.

GPs around the country reported massive delays in agreeing plans to redesign care in place with primary care trusts.

GPs said PCTs' approach towards developing practice-based commissioning was dysfunctional and incompetent and undermined their own efforts to get the scheme off the ground.

Some 70 per cent of GPs said they did not have a locally agreed plan in place. Nearly two-thirds of those without a plan did not expect to have agreed one by the end of June ­ the point at which ministers had hoped all plans would be in.

The straw-poll of 30 GPs also revealed only 27 per cent had governance and accountability data arrangements in place; 23 per cent had received an indicative budget; and 17 per cent had received local and national clinical and financial benchmarking data.

Dr Dermot Ryan, a GP in Loughborough, Leicestershire, said practice-based commissioning was a joke in his area.

'Our PCT is not willing or able to assist us in setting up

robust contracts with penalty clauses for poor performance with our local trust,' he said.

'Were GPs in control of commissioning and the process had teeth, we might see some true modernisation of the NHS, but while we remain having our eyes blindfolded, our mouths gagged and hands and feet bound, nothing useful is going to happen.'

Dr John Cormack, a GP in Woodham Ferrers, Essex, said the freedom of commissioning groups to do what they think is best for their patients was in question and accused his PCT of attempting to foist their employees on to commissioning structures.

'Our PCT seems to want to tie the hands of GPs by getting them to sign up to agreements which give the old organisation more power than would be the case if the best interests of the scheme were the only consideration.'

Dr David Bellamy, a GP in Bournemouth, said he was becoming disillusioned about the scheme and beginning to doubt it would help patient care.

Dr Andy Seymour, chair of Gloucestershire LMC, said the countrywide target of 2 per cent reduction in hospital activity would be hard to achieve.

Dr Hank Beerstecher, a GP in Sittingbourne, Kent, said GPs should not be expected to solve PCT deficits. 'If they cannot make ends meet, why should I be able to?' he said.

Only one GP, Dr Alexander Williams of Exeter, had a positive experience to recount. He said: 'We have made significant savings in year one so are quite excited about commissioning additional services for unmet patient need.'

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