PCTs are rejecting the majority of proposals from GP practices for service redesign, hindering the roll-out of new services under practice-based commissioning (PBC).
A survey, carried out by Ipsos MORI on behalf of the DoH, found that 32 per cent of practices in England that have submitted business plans for new services have had all of them rejected. A similar number has a mixed response.
Only 19 per cent were given the go ahead for all new services.
Fifty-nine per cent of practices have yet to commission any new services under PBC.
Dr Richard Vautrey, deputy GPC chairman, blamed the figures on the lack of support from PCTs: 'Partly it is because of their reluctance to allow PBC groups to move forward and develop things.'
'And partly it's because the lack of management support means that practices aren't able to develop business cases in the way that is expected'.
He called on PCTs to do more to support practices, and for the government to 'work with GPs'.
'The more the DoH takes an unacceptable line on contract negotiations, the more reluctant GPs will be to engage in these initiatives,' Dr Vautrey said.
The survey reveals a pattern of slow progress but also gradual improvement compared with the last survey, published three months previously.
Fifty-nine per cent of GPs are now supportive of PBC as a policy, compared with 57 per cent in wave one and also 54 per cent of practices have agreed a commissioning plan with their PCTs, compared with 46 per cent in wave one.
However, only a third of practices rate the quality of information from their PCT as good.
32% of practices had all PBC business plans rejected by their PCTs