Addressing an audience of GPs in Halton, Merseyside last week Mr Lansley was asked how smaller consortia would be able to cope with financial risk and exceptionally expensive patients.

He said organisations formed from either charities, PCT staff or the independent sector would help consortia across England design services and ‘offer to take on the risk’ of the associated costs.

‘You can say [to a commissioning support organisation] here is the standard we are looking for, we want you to put a commissioning framework in place, and you can take on that risk,’ he said.

‘I think you will see lots of organisations from charities, the voluntary sector or people currently working in PCTs -  and these organisations will start to offer to take on these risks,’ he said.

Mr Lansley said he had talked to charities such as Parkinson’s UK, which, in partnership with other groups, has formed Neurological Commissioning Support to design neurology services. 

Sue Thomas, head of Neurological Commissioning Support, said the group had been working with PCTs for four years. ‘As a charity we know what should be in place,’ she said. ‘The risk is lessened because of the knowledge we have around the country.

‘PCTs don’t always know how much they are spending on neurological problems. We can map the services people currently use and find how many people suffer from neurological problems in their area.’

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