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Worry over proving quality score

Strategic health authorities are ordering PCTs to use unspent enhanced service cash to pay off hospital deficits, GPC negotiators are claiming.

Up to four authorities are accused of giving the directive, which breaks contract regulations.

GPs have reported many PCTs are underspending on enhanced services and some trusts, such as East Lincolnshire PCT, have admitted they are falling short.

GPC deputy chair Dr Laurence Buckman said negotiators planned to raise the issue of underspends at their next meeting with NHS Employers.

'I've had several GPs saying they know their health authority has been saying this [to their PCT],' he said. 'It's not just one SHA but three or four ­ and that could be an awful lot of PCTs. You cannot divert money from the enhanced services floor to spend on other things. That is against regulations.'

As many as 40 PCTs are thought to have been given the order. Negotiators refused to name the health authorities at the centre of the row.

However, Dr Stewart Drage, who is also co-chair of Londonwide

LMCs, said he had written to the chief executive of one of the capital's health authorities to demand a detailed breakdown of how its PCTs were meeting their enhanced service floors. 'Our concern is that an SHA is being told it doesn't matter if there's an underspend as long as the secondary care deficit is met,' he said.

'We are in the ludicrous situation where PCTs, established to promote primary care, are unable to deliver improvements in primary care let alone general practice.'

Chris Town, lead negotiator for NHS Employers, said it was 'complete news' to him that health authorities were giving such orders.

He said he would not stand for contract rules being broken in this way. 'We are quite clear what the agreement is,' he said. 'The floor must be met in each PCT.'

Dr Drage added that some trusts were still including inappropriate activities in their enhanced services spending in order to meet their floor.

By Ian Cameron

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