The guidance, distributed by NHS Primary Care Commissioning, has been withdrawn by the DoH after GPC complaints about its ‘threatening' tone.
But GPC chairman Dr Laurence Buckman admitted talks with the DoH are still ongoing over whether practices overloaded with swine flu can suspend services without being hit financially.
The guidance says GP practices should talk to their PCT about services they may be unable to deliver, and PCTs ‘have discretion' to offset losses.
But it says that ‘certain financial consequences would be automatic'. It explains that if an additional service ceases, ‘a deduction must be made', a directed enhanced service ‘cannot be paid for if it is not delivered' and ‘childhood immunisation payments cannot be made if targets are not met'.
Dr Buckman said the GPC and the DoH were currently negotiating a solution so that it ‘never gets to that stage'.
But he warned: ‘The thing to do is not to withdraw services without entering into discussions with your PCT - you will have funding cut, it is in your contract.'
He added: ‘We are negotiating to get the letters written up properly and not worded in a way that will scare people. The letter is amazingly unfortunately phrased. I can see why any practice would look at it and think "what on earth is this?".'
Earlier this week all four UK governments announced that practices would be paid £5.25 for administering each swine flu jab.
- Read the full version of this story in this week's GP dated 18 September.