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PBC unviable in places

Practice-based commissioning is being made 'unviable' in many areas because of a decision to top-slice practices' indicative budgets, GPs warn.

Practice-based commissioning is being made 'unviable' in many areas because of a decision to top-slice practices' indicative budgets, GPs warn.

The Department of Health has advised PCTs to slice between 3 and 5 per cent off the budgets allocated to practices to act as a contingency fund.

The move has been prompted by a Government decision to top-slice PCTs' overall budgets by 3 per cent in an effort to cut the rising NHS deficit.

Another cash-saving tactic being used by trusts is to set a target for GPs to make savings and deduct that figure from budgets at the start of the year.

In Brent, west London, the PCT has stipulated a 4.7 per cent savings target and sliced that amount from GPs' budgets.

Dr Hamish Meldrum, GPC chair, said the problems were sapping GPs' interest.

He said: 'A lot of colleagues are having any interest in PBC they might have had totally removed. It's "What happens to deficits?" and "What budgets would we get?".'

Dr James Kingsland, chair of the National Association of Primary Care and a GP in Wallasey, Wirral, said practices in the South-East would be particularly affected because the market forces factor would also be reduced.

He said: 'In an area where there is already financial pressure, it will make it potentially unviable for some of the more specialised practice-based commissioning ideas. The cutting edge could be blunted.'

Dr James Gilgrass, chief executive of Surrey and Sussex LMCs, said GPs in the region were now 'really struggling with practice-based commissioning'.

He said: 'There's growing disillusionment ­ if this is added on it's not going to be conducive.'

Many GPs are still waiting for indicative budgets and have reported that PCT restructuring has further hampered progress.

Dr Richard More, a GP in Yeovil and former commissioning lead for Somerset LMC, said GPs in the area had been told they would not get an indicative budget until June.

Dr Meldrum said: 'That's symptomatic of a few areas, particularly where you have had eight PCTs go into two.'

But he warned that GPs who were put off commissioning by delays or budget cuts would find they had no control over other commissioners doing the work for them.

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