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PCTs plan radical cost-cutting programme for GPs

By Ian Quinn

Exclusive: GPs are to be presented with a doomsday scenario by NHS managers claiming the health service will be financially crippled unless they sign up to huge cuts in spending and service reconfigurations, documents reveal.

Trusts across England say it is vital to ratchet up the Department of Heath's Quality, Innovation, Productivity and Prevention (QIPP) programme, with Pulse discovering savings in many areas have fallen way behind target.

NHS London has given its 32 trusts until 15 October to come up with proposals to present to GPs to massively reduce spending in 2011/12 and 20013/14, despite £174m being cut this year already.

A confidential document obtained by Pulse says ‘London no longer has a legitimate medium-term financial strategy', and without radical action ‘it's unlikely financial health and clinical quality will be maintained or improved in 2011/12 and beyond'.

It urges trusts to ram home to GPs the cost of ‘doing nothing' and calls on them to draw up a list of proposed cuts including decommissioning hospital services and ‘implementing GP-led networks in care centred on polyclinics'.

NHS managers across England are warning that trusts - and the GP consortia that take over - will be left tens of millions of pounds in deficit, unless GPs consent to radical cost cutting. It follows our findings last week that trusts are already slipping into the red.

Of 15 trusts providing figures on QIPP performance, nine were behind target. NHS Tower Hamlets predicts it will plunge £37m in the red by 2013/14 unless it wins GP backing for cuts, with the figure across north-east London £114m.

Dr Sam Everington, a GP in Tower Hamlets and the PCT's integrated care lead, told Pulse: ‘The message I'm getting is all about major cuts that have to be made across the board. It's quite stunning considering the emphasis previously has been on maintaining spending on the NHS.'

NHS Dorset and NHS Bournemouth and Poole, having recruited US consultant McKinsey, revealed plans to slash spending by £200m in three years and to talk GPs into backing them. A report sets out plans to save more than £35m by shifting care to GPs from hospitals, more than £30m by ‘improving' primary care.

‘This plan has not been agreed with providers, local authorities and potential consortium leaders,' it admits, but ‘provides a staring point for discussions about savings'.

The PCTs aim to ‘secure support of GP consortia' by October, adding there needed to be a ‘significant change in the way resources are allocated and changes in the model of care'.

Dr Jon Orrell, a GP in Weymouth, Dorset, said: ‘The only way they are going to make these savings is by cutting services and it's up to GPs to fight against it.'

A string of trusts are drawing up plans to ramp up QIPP targets. NHS South Gloucestershire said it was £5.8m behind on its £14m QIPP target for 2010/11, and NHS Brighton and Hove £2.4m behind target.

PCTs plan radical cost-cutting programme for GPs What is happening in your area?

Click here to find out which PCTs are forecasting major end-of-year deficits or taking emergency measures to avoid debts.

Read the guidance in full

To read the full version of NHS London's planning guidance, please click here.

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