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Ministers miss key deadline for PBC as chaos dogs scheme

Practice-based commissioning is falling way behind schedule, with more than half of GPs shunning the scheme due to a catalogue of problems.

Only two out of five GPs have so far signed up amid doubts over their ability to keep savings and unreasonable demands being set by PCTs desperate to save money.

Even those GPs who have agreed local plans are claiming the process has been a worthless exercise.

A Pulse survey of 61 PCTs covering 2,038 practices has found just 38 per cent of GPs had agreed a local plan with their PCT by the end of June.

The figure compares with a Government target for all practices to have agreed the plan, which triggers the first 95p per patient directed enhanced service payment, by 30 June.

Department of Health figures released this week showed that by the end of May, 41 per cent of practices had received the DES payment.

But in Kent, Hampshire, Somerset and Dorset, no GPs had signed up.

Despite having come nowhere near the target, health minister Lord Warner said the fact 3,454 practices were involved showed the NHS was 'surging ahead' in adopting the Government's reforms.

Dr Robert Morley, secretary of Birmingham LMC, said Eastern and North Birmingham PCTs had set out their own plan, rather than waiting for GPs to develop one, and top-sliced indicative budgets.

'The prospect of any savings coming out of this is virtually nil,' he said. 'Practices are wising up to what they are being asked to sign up to.'

Dr David Bellamy, a GP in Bournemouth, said he had still not received his DES part one payment, despite having submitted a plan. He said: 'We're all floundering away, not really knowing what we're supposed to be doing.'

Dr Richard Lewis, acting director of policy at the King's Fund, warned the figures only showed how many practices had taken up payments, not how many were commissioning effectively. 'A big issue for GP practices is whether they will get to keep savings they make.'

The department this week guaranteed that PCTs can only

dip into practices' 70 per

cent share of savings if the GPs agree.

Dr Michael Dixon, NHS Alliance chair, said this may trigger 'horse-trading' by trusts, but would put the decision firmly with the practice.

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