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Total purchasing schemes face budget problems

BMJ 1996; 313 doi: (Published 09 November 1996) Cite this as: BMJ 1996;313:1166

General practitioners who are piloting total purchasing schemes are wrestling with budget setting problems and worries about increasing workload, a national evaluation has found.

Doctors in 83% of the 53 general practice projects in the government's total purchasing experiment are finding it difficult to agree on how to set budgets; a figure for 1996–7 has not been set for one in five of the projects.

Preliminary findings from a study led by the King's Fund Policy Institute show that most lead general practitioners are worried about the extra workload imposed by total purchasing. Some are also concerned that the scheme could cause stress in their relationships with colleagues and fear that …

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