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Rethink on ?-blocker use

GPs will find it harder to save money under practice-based commissioning after ministers toughened up rules for the scheme to protect PCTs.

New guidance gives trusts the power to keep back part of the commissioning budget from practices as a 'contingency' in case GPs overspend. The move comes after PCTs complained bitterly that they had to shoulder all of the financial risk while GPs kept any savings.

Under the revised guidance, GPs can keep up to 100 per cent of any savings they make by taking over commissioning from PCTs ­ up from 50 per cent ­ but they will face greater scrutiny from PCTs on how they spend the money.

Dr David Jenner, NHS Alliance GMS and PMS contract lead and a GP in Collumpton, Devon, said the guidance gave trusts more control. 'This gives more accountability and regulation but I see the removal of the 50 per cent cap as a means of increasing incentives for GPs.'

Chris Town, chair of NHS Employers GMS negotiating team, said PCTs now had a 'pivotal role' in agreeing how financial risk was managed. He said: 'I think to PCTs, the first draft felt like practices could do what they wanted, and if they overspent the PCT had to find the money.'

The guidance reiterated savings must be spent on patient care and would not be for individual profit.

Practices' plans for spending savings must now be approved by both professional executive committees and PCT boards.

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