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Watchdog hits out over PCTs' deficits

A failure to involve clinicians in management decisions has been a major factor in the massive deficits racked up by PCTs and NHS trusts, a public spending watchdog has found.

A report from the Audit Commission argues trusts with the worst deficits suffered from 'mediocre' management and 'weak or inadequate' leadership.

The report, Learning the Lessons from Financial Failure in the NHS, also found the boards of the 25 worst-hit trusts 'took their eye off the ball' as a result of mergers and other major events.

Where clinicians were 'disengaged' from policymaking, 'this was a reliable indicator of impending trouble'. The commission added: 'It is, after all, clinicians who spend most of the NHS's money.'

Steve Mercer, chief executive of Avon LMC, which includes Kennet and North Wiltshire PCT, one of the trusts highlighted, said GPs' time must be properly reimbursed if they were to take part in meetings.

Managers were often told what to do by government, he added. 'Therefore to have practical people to say "implementing this would create this problem" actually confuses the issue.'

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