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Trusts seize PBC for 'performance management tool'

PCTs are flouting Government guidance on practice-based commissioning by turning it into a tool to performance manage GPs.

Several trusts are also trying to impose tough conditions on GPs' commissioning powers without negotiating with practices first, Pulse has learned.

The actions come despite comments by Patricia Hewitt at a recent NHS Confederation conference imploring PCTs to 'really support GPs' to get commissioning off the ground.

Heart of Birmingham PCT has told GPs they will have to sign up to 32 separate targets to get the first 95p per patient directed enhanced service payment.

GPs will then have to hit five key targets on flu vaccination, cervical cytology, ethnicity re-cording, outpatient admissions and emergengy bed days to get the second part of the DES or keep savings.

If they fail to hit the emergency bed days target, already identified by the trust as 'very challenging', they will lose half of the money.

Dr Robert Morley, Birmingham LMC secretary, said the PCT was flouting Government guidance and had not agreed the plan with GPs.

Dr Morley said: 'It's unacceptable. If we don't get this changed, we'll inform practices of the implications of what they might be signing up to.'

A spokeswoman for Heart of Birmingham PCT said its plans had been agreed with 'clinical leaders'.

In North Yorkshire, Craven, Harrogate and Rural District; Hambleton and Richmondshire; Scarborough, Whitby and Ryedale; and Selby and York PCTs have told GPs they will

not get DES payments for procedures which are 'not in line with the PCT commissioning arrangements'.

Dr Brian McGregor, a GP in York and a commissioning consortium member, said: 'I suspect performance managing is going to come into primary care in a way that we've never had to face before.'

Dr Paul Roblin, chief executive of Thames Valley LMCs,

said PCTs in the region were

trying to include targets

which were 'tantamount to unachieveable'.

He said: 'It's rife across the whole system. They're all trying to copy each other.'

He added: 'I'm expecting a battleground. When practices submit their plans and don't commit to these objectives, we'll have practice plans being rejected.'

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