NHS England published plans for cuts to primary care support services and further outsourcing ahead of a meeting due as GP went to press.
Primary care support teams, also known as family health services (FHS), handle GP payments and administration of medical records, performers lists and patient registration. The services were previously run by PCTs, but moved over to NHS England in last April's reorganisation.
Early details of the plans, which could take effect from September 2014, were revealed exclusively by GP earlier this year (GP, 30 September).
NHS England has now confirmed the cuts could see the number of regional FHS offices slashed from 37 to 12 and savings of £40m targeted from a £100m overall budget.
GPC deputy chairman Dr Richard Vautrey said practices already facing regular payment problems would be 'very concerned this could get worse because of these planned cuts'.
He called on NHS England to improve the service urgently and 'explain to practices how it will guarantee a high quality and timely service following these cuts'.
Further FHS functions could be outsourced in future, NHS England board papers reveal. About 30% of NHS England's 27 area teams provide primary care support services in-house, with the rest outsourced to NHS Shared Business Services (SBS) or private providers such as Serco.
The plans come as GPs and practice managers continue to report payment problems. Practice managers in the north-east of England say payment problems have left practices facing closure.
Philip Horsfield, a practice manager in North Tyneside, has asked the health secretary to abolish SBS, which handles payments in his area, warning that his practice faced its worst cashflow problems ever.
GPC member Dr George Rae said the system was 'antediluvian'. He warned £40m cuts would have a 'drastic effect'. 'It makes a mockery of everything we are trying to do and makes it almost impossible to transfer services to primary care.'
An SBS spokeswoman recognised payment problems were causing difficulties for practices and said it was working with NHS England and others to rectify them.