The comments came after the North Central London PCT cluster published a report last week setting out its vision for developing primary care.

GPC chairman Dr Laurence Buckman, whose Barnet practice is in the cluster, condemned the report as ‘nothing to do with the GPs of north London’.

Londonwide LMCs medical director Dr Paddy Glackin said it revealed a lack of clarity over the roles of CCGs and clusters in planning NHS reform.

The report, Transforming the primary care landscape in north central London, offers ‘pump priming’ cash for primary care across five London boroughs in return for changes to the way practices work.

To access the funds, practices must agree measures including:

• Sign up to local networks and join a development programme.
• Sign up to a ‘super local enhanced service (LES)’ to increase the range of added services they provide.
• Upgrade premises to agreed standards or be moved.
• Link up to a cluster-wide IT system and adopt electronic patient access devices.
• Display and distribute all cluster patient literature.
• Agree a set number of appointment slots per week.

In a statement, the cluster said its plan was not being imp­osed on GPs, but ‘has been co-produced with a range of stake­holders, including GPs and others working in primary care – and is very much a joint production’.

The plan says the investment in primary care is ‘mutually beneficial’ and ‘requires independent contractor practices to achieve explicit quality stan­dards of inputs and outcomes in return’.

However, Dr Glackin, a GP in Islington, said: ‘LMCs have not agreed or accepted the strategy.’

He acknowledged variations between practices, but said there was no evidence of widespread poor practice.

‘We want things developed in a bottom-up manner. The people responsible for planning healthcare for the community are meant to be the CCGs, not the cluster.’

Dr Buckman said the cluster’s report amounted to a ‘rewriting of the GP contract’.