PCTs are set to slash GP services, slim down urgent care and put pressure on referral and prescribing rates to cut costs, GP can reveal.
PCTs across England outlined the plans in operating and strategy reports for 2010/11.
Plans to reduce GP contract spending - likely to mean cuts to enhanced services and PMS deals - will increase pressure on practices hit hard by PMS contract reviews this year (GP, 25 February).
NHS Peterborough alone aims to save £4 million from GP contracts and payments over 2011/12 and 2012/13. Its 'turnaround plan' proposes 'cessation and capping' of local enhanced services, cutting variation in payments per patient to GP practices and stopping two to three GP APMS contracts'.
GPC negotiator Dr Peter Holden said: 'We've been hearing stories of (cuts from GP contracts) all over the UK over the past week, and I do not understand what PCTs are up to.
'PCTs need GP co-operation, and it's hardly the time to cause non co-operation with GPs. PCTs need to understand that if it isn't resourced then we can't do it.
'People keep talking about efficiency savings, but if it costs us to do it then an efficiency saving means a pay cut for us.'
NHS Peterborough hopes to find around £74 million in total savings over 2011/12 and 2012/13. Around £13 million could come from primary care, including cuts to walk-in and out-of-hours services.
Meanwhile, NHS Brighton and Hove plans to slash GP out-of-hours costs by around £310,000 and NHS Harrow has already saved £45,852 on out-of-hours this year.
A spokesman for NHS Harrow said this was achieved by a 'change in the provider that triages patients to the service'.
Several PCTs aim to save money by increasing management of GP referral and prescribing rates. NHS Peterborough hopes to save £800,000 a year over 2011/12 and 2012/13 from referral management, and £3.1 million on prescribing.
NHS Western Cheshire planned to continue its 2009/10 prescribing cost cuts, while NHS Hounslow aimed to manage referrals 'more effectively'.
Dr Holden said walk-in centres were often an 'expensive luxury'. But he warned: 'I would counsel PCTs to be very careful with out-of-hours.
He added that he knew of one out-of-hours provider which had problems because of an under-resourced contract. He urged caution over cutting GP referrals and prescribing.
'People don't refer for no good reason at all. They refer because something needs doing.
'If a patient is in front of you that has a clinical need then we are obliged to fulfil that clinical need.'
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