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No incentive to increase savings

Practices that have already made savings through practice-based commissioning are complaining they have little incentive to make further improve- ments this year.

GPs involved in the early stages of commissioning made savings by validating hospital data and reducing emergency hospital admissions.

But because indicative budgets are based on historical data from last year, opportunities to make further gains are limited.

The problem should be solved once budgets are moved to a 'fair shares' basis, but Government guidance tells PCTs to make only slow and cautious progress towards this.

Dr Phil Taylor, a GP in Axminster, Devon, and a first-wave practice-based commissioner, cast doubt on how the scheme would work in future.

He said: 'I can't see how

fair shares won't run into the same problems as the Carr-Hill formula.

'If you have good access and are able to identify and refer

serious illness you may well be spending more than a practice with poor access that doesn't address these things.'

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