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BMJ 2000; 320 doi: (Published 22 January 2000) Cite this as: BMJ 2000;320:255

GPs given advice on primary care trusts

Thirteen primary care trusts (PCTs) will start work in England on 1 April. A typical trust will control over 80% of health spending on its local population and will have new powers to provide local health services such as community nursing, community hospitals, and services for the elderly. They will be able to work with hospital doctors to determine how other services are provided and to enable more services to be delivered closer to patients.

The General Practitioners Committee has prepared guidance on the implications of PCTs for GPs, practices, local medical committees, and the GPC and sent it to local medical committees and chief executives of primary care groups.

The GPC believes that for individual GPs their day to day work will probably change little but there is likely to be increased clinical accountability. There will be greater contractual choice and in a PCT area there may be pressures to become salaried GPs. GPs may find there is increased tension between their role of patients' advocates and that of delivering PCT managed health care. Primary care will increasingly be delivered by larger teams of multiskilled professionals with greater integration of …

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