Practices will also be forced to make savings by tough pay deals, top GPs warn.
DoH national clinical commissioning lead for England Dr James Kingsland said practice-based commissioning groups had already looked at how practices could cut administrative costs.
His comments come after a DoH-commissioned report called for practices to make savings by sharing 'airline check-in' style appointment systems (GP, 26 November).
'Practices that had comfortable relationships with like-minded practices went into limited liability models for commissioning,' Dr Kingsland said.
'Once you've done that, the next stage is to ask: should we look at being more efficient by consolidating premises, staff or one practice manager taking a lead on payroll? You retain the uniqueness for the purposes of practice lists but your overheads are reduced.'
But he warned that practices would have to be 'very careful' that sharing back office functions was the right move.
'What if you are sharing lots of back office staff with your colleagues but then you want to move consortia?' he said.
Conservative Medical Society chairman Dr Paul Charlson warned that sharing appointment systems could be a 'chaotic nightmare'.
But he added: 'There are things practices could get together on to use economies of scale. Human resources and payroll functions can be done as a bigger set-up.'
It was inevitable there would 'not be a lot of money around' and the DoH would ask practices to make efficiencies, he said.
Dr Kingsland agreed that efficiency gains would be part of future GP contract negotiations. 'It's inevitable. It would be naive to think that there won't be a link between performance as commissioners and income as practices.'
NHS Alliance GMS/PMS lead Dr David Jenner said practices were already making savings by federating and sharing administrative staff.
'We'll see more federation and mergers of back office functions. But not on day-to-day contact with patients,' he said.
