PCTs are undermining practice-based commissioning (PBC) by snatching back any savings they have made, GPs have warned.

PBC allows practices to band together to commission the services that will most benefit their communities. But despite the fact that the initiative increases practices' control over health services, support among GPs has been slow to build.

Now Dr David Jenner, GMS contract lead at the NHS Alliance, has said he is 'seriously worried' about the future of the initiative.

'I've seen PCTs reclaiming all the savings made,' he told last week's London conference. 'So the trust has gone and the incentives (to take part) are gone.' Such clawbacks seem to be happening in many parts of the country, he said.

One GP, Dr Jaweeda Idoo, told a recent King's Fund conference that her consortium, Stockport Managed Care, had felt 'really invigorated' after it saved £1 million through PBC. But 'when the PCT went into deficit it refused to give it to us', she said.

Dr Michael Dixon, chairman of the NHS Alliance, described this behaviour as 'bad management'. Consortia should 'receive enough to motivate them again next year', he said.

A recent GP newspaper survey found that just 16 per cent of GPs feel positive about the future of PBC - fewer than half the 39 per cent who feel negative (GP, 17 April).

The largest contingent (45 per cent), feel neither positive nor negative - suggesting a large portion of the profession is simply not engaged in the policy.

jonn.elledge@haymarket.com

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