These are among the key lessons PCT commissioners have said GPs should remember when they take on commissioning responsibility  from 2011/12.

Tony Ullman, NHS Manchester’s associate director commissioning central hub, advised GPs to have a ‘collaborative approach’ with the acute sector to share problems and agree pathways.

At the same time he said GPs should agree with hospitals how they can become more efficient or reduce capacity.

He said: ‘Be as strong as you can about contracting with acute hospitals. It’s not just about what you agree, but how you manage demand and activity and monitor what is happening so you only pay what you have to pay for.

‘GPs should be checking the [hospital] bills, and validating [hospital] activity.’

Mr Ullman also said consortia should be ‘cohesive’ and have a shared understanding of what is trying to be achieved.

He said: ‘Make sure that clinicians are talking to others on the ground about what is happening and share good practice. Each practice should be signed up to deliver what is needed, so you don’t end up with outliers or poor performers.’

Mr Ullman also cautioned that commissioning is ‘complicated stuff’ that is often more complex than GPs believe.

He said: ‘GPs sometimes get frustrated by the pace of change with some areas of PCTs. But, it [commissioning] is often more complex than GP commissioners have been exposed to. Setting up a new service can pose a risk somewhere else, you need to understand the whole system.

‘GPs up to now have not been responsible for commissioning the whole pathway.’

Meanwhile John Parks, chief executive of NHS Northamptonshire, said a key point for GPs is to ensure they ‘don’t lose a grip on the money’.

He said: ‘In the first six months it is really easy to spend money, but it is much more important to understand the real needs of your population.

‘Once you have lost a grip on the money it is quite difficult to get back in a balanced position.’

Mr Parks highlighted that GPs should move from a ‘spending regime’ to an ‘investment regime’.

He said: ‘GPs need to understand where they are getting the greatest return for each decision made and understand the resource implications of those decisions.

‘Understanding that will be done by really good consortia.

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