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Independents' Day

PCT mergers leave GPs in limbo

By Emma Wilkinson

Practice-based commissioning and other key primary care developments have come to a grinding halt because of PCT mergers.

GPs say the NHS is suffering a management vacuum that is

severely hindering their ability to plan. Efforts to reduce deficits are also being hindered by uncertainty over leadership.

With a week to go until new PCTs come into existence, many do not yet have chief executives or management structures in place, said LMCs.

Thousands of staff also do not know whether they will have jobs in the new trusts.

Dr John Canning, secretary of Cleveland LMC, said GPs in the region were getting increasingly anxious about practice-based commissioning.

He said: 'Decisions are more difficult to make with the uncertainty of not knowing if your PCT is going to exist or what it's going to look like.'

Dr Paul Golik, secretary of North Staffordshire LMC, said those PCTs in dire straits financially were suffering from lack of strong leadership.

He said: 'You can't make plans because you don't know who's going to scupper them.'

A Government review of professional executive committees, which ensure clinical engagement in PCTs decision making, announced last week, has added further confusion.

Some PCTs will have to restart their committees, others will have to set up new ones.

Dr Brian Balmer, secretary of Essex LMCs, said PCTs in the county were 'totally moribund'.

He said: 'There's no one making any decisions and what progress there has been in practice-based commissioning has been slowed.'

PCTs were being forced to continue with existing committee structures because they did not formally know how they would be constituted until next April, said Dr Balmer.

The 303 PCTs in England are being cut down to 152. Only London, where the 31 PCTs remain, has stayed relatively untouched.

Dr Harry Yoxall, secretary of Somerset LMC, where four PCTs are merging, said GPs were still waiting for their PBC budgets.

He said: 'In common with many other LMCs, we're worried about the lack of obvious continuity planning.

'We don't have an appointment for a chief executive. The NHS is evolving so quickly, we need people who are able to make strategic decisions and that's a problem.

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