England’s GP commissioning consortiums will fail without substantial investment in management and technology that is driven by capable leaders, a study of systems in the United States has warned.

Strong management will be vital when the new GP consortiums take charge of most of the NHS budget from 2013, says the report from the health policy think tank the Nuffield Trust.

The report examines the US experience of handing the equivalent of commissioning budgets to doctors over the past 20 years—which has met with mixed success.

Senior researchers from the trust visited four medical groups led by doctors in California. Around 2000 doctor led networks and groups emerged across the US from the mid-1980s. …