As we reported last week, PCTs are planning to cut millions from primary care contracts this year, via reductions in GMS and PMS spend, cuts to enhanced services and restrictions on investment in premises.

Meanwhile, in this week's issue, Dr James Kingsland, of the National Association for Primary Care, predicts that the number of practices holding PMS contracts will be significantly reduced as PCTs target them for savings, forcing many back to GMS.

We still await the Doctors' and Dentists' Review Body's recommendations on the GMS pay award for 2010/11, but it is already clear that the government does not want practices to receive any significant uplift. The Treasury has argued for a pay freeze and the DoH has called for practices to find efficiency gains of 1 per cent during the financial year.

With efficiency being the buzzword across all areas of the public sector, it seems almost certain that GPs will be encouraged to do their utmost to make savings, either through this year's pay deal or by other levers, such as balanced scorecards.

However, after successive years of pay freezes and only a minimal increase last year, which took place during a period of rising expenses, many practices have already done what they can to cut costs. With inflation on the rise again, it is hard to see what more GPs can do to deliver the efficiencies the government craves.

GPs are being squeezed from every angle. It is therefore essential that practices are on top of every aspect of their business.

Maximising all possible income streams, and making sure your practice receives everything it is entitled to, is now vital and this week's news about notional rent could be a cash windfall that many practices find they deserve.