Practice based commissioning is failing to deliver the benefit for patients envisaged by the government because of a lack of incentives to get GPs on board, says the public spending watchdog.

The policy to devolve responsibility for commissioning services from primary care trusts to general practices at the local level was introduced in 2005-6 and is a main plank of the NHS reform programme. But the Audit Commission says it is suffering from poor support from primary care trusts for GPs to develop projects—including accurate information on budgets, what savings have been made, and how these savings could be used to develop other services.

“Unless you get the financial infrastructure right it [practice based commissioning] won't work,” said Andy McKeon, …