Nearly all English general practices are set to run their own budgets

doi:10.1136/bmj.39202.341609.DB

BMJ 2007;334:922 (5 May), doi:10.1136/bmj.39202.341609.DB

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Nearly all English general practices are set to run their own budgets

Zosia Kmietowicz

London

Almost all general practices in England have signed up to practicebased commissioning and are preparing to draw up plans to takecontrol of their own budgets.

Figures from the Department of Health show that as of Marchthis year 96% of practices have been receiving incentive payments—anationally negotiated "directly enhanced services payment" ora local alternative—which commits them to practice basedcommissioning.

Although the payments mean only that practices need to startplanning how they will commission hospital and community services,the government wants to see all GPs adopting practice basedcommissioning by 2008.

The government believes that widespread use of the system willreduce admissions to hospital, because under the scheme GPsare able to keep at least 70% of the savings they make by directlycommissioning services. They can then use the savings to developspecialist services within their own practices by investingin diagnostics, equipment, specialist care, or staff.

Uptake of the incentive payments has been increasing steadilysince the scheme was launched in April 2005. In May last yearjust 40% of English practices were receiving the incentives.

Evidence from early adopters of practice based commissioningshows that practices have cut the number of patients referredfor hospital treatment by between 25% and 33%. A 25% reductionin referrals across the country would mean 2.5 million fewerhospital appointments.

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