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Trusts are excluding LMCs from policymaking for GPs

Primary care trusts are sidelining LMCs over key policy decisions affecting GPs, research for the BMA has found.

The survey of LMCs in England found 53 out of 87 had been inappropriately excluded from policymaking by trusts.

LMCs reported being 'generally peripheralised' by managers. They also complained that they face increasing burdens through having to deal with several PCTs and a strategic health authority.

Dr Charles Zuckerman, chair of Birmingham LMC, said 'one or two' of four PCTs it covers had tried to sideline the committee. 'They thought they could get all their medical and worldly advice from their professional executive committee,' he said.

He added: 'We used to have one health authority for all of Birmingham but now have four ­ it's a postcode lottery. Each PCT makes up its own policies.'

Dr Tony Welch, secretary of West Sussex, Kingston and Richmond LMC, said 'ignorance' among PCTs' staff often led them to sideline LMCs because they did not know they needed to consult.

The report, carried out by the School of Health and Related Research at the University of Sheffield, also warned that small 'unitary' LMCs will find it increasingly hard to remain cost-effective.

It advised smaller LMCs

to consolidate into large

confederations such as Wessex and London LMCs to take

advantage of economies of scale.

The study also found

LMCs had difficulties collecting levies from non-principals and recommended an increase in fees for principals to cover the shortfall.

Practices would then have to recoup the levy from locums.

Levies for principals averaged £500 a year but varied from £260 in Cheshire South to £800 in Devon.

Budgets ranged from £25,000 in Dudley to £2 million for the combined London LMCs.

Almost half of LMCs reported little or no contact with the BMA's regional offices, with one commenting they were 'useless.'

Most LMCs also said their links with other professionals such as pharmacists and dentists were 'ad hoc' at best.

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