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GPs should take on the risks of overspends from practice-based commissioning, a leading academic has proposed.

Dr Richard Lewis, fellow in health policy at the King's Fund, told an NHS Confederation conference that PCTs

were worried about having

to shoulder the financial

risk when GPs took over


Negotiations on the future of the scheme should 'go beyond' an enhanced service to incentivise GPs for taking on commissioning, currently being negotiated between the GPC and NHS Employers, he added.

But GPs said the financial risks involved in commissioning were too high for practices.

Dr Hamish Meldrum, GPC chair, said: 'We could be talking about millions of pounds which would swamp any GP profit.'

He added that a reward of 'bonus' points for commissioning practices, akin to the access target in the quality framework, was on the cards as a incentive for GPs.

Dr James Kingsland, chair of the National Association of Primary Care, said trusts could lower the risk of overspends by engaging GPs. 'If we have a scenario where there is a non-indicative budget then it might affect your business,' he said.

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