Other PCTs admitted diverting the funding to pay for GP-led health centres and balanced scorecards.
In March 2008 the GPC accepted a contract deal with a ‘guaranteed 1.5% investment in general practice', worth £105m. From this, £50 million would go towards new clinical enhanced services, £5m into the global sum, and £50m could be used by PCTs to ‘improve access and responsiveness in GP services.'
In September 2008 Mark Britnell, NHS director general, wrote to all PCTs instructing them to use the £50 million access cash to raise all local enhanced service (LES) payments by 20%.
But of 65 PCTs to respond to a freedom of information request by GP, just half spent the money on local enhanced services. A third (36%) had not invested the cash in primary care services and 43% could not provide a conclusive breakdown of how the money was spent.
Seven PCTs used the cash to fund GP-led health centres and two spent it on developing balanced scorecards to performance manage GPs. The majority of PCTs that had spent their allocation of the money used it to offset the cost of extended hours.
A further seven PCTs could find no record of even receiving any of the £50m.
GPC deputy chairman Dr Richard Vautrey said very few practices have seen evidence of investment that would improve services for patients.
Dr Vautrey said the GPC was ‘well used to money not being ring-fenced and therefore being spent in other ways, often to fund deficits in other PCT budgets.' The GPC ‘is in dialogue' with the DoH about recovering the money.
PCT network director David Stout said PCT spending on LESs rose from £251m in 2007/8 to £323m in 2008/9.
‘I think it's down to the way PCTs receive their allocations. There is no cash as such ring-fenced for the GP deal. But in terms of what has been spent there has been more than the investment mentioned in the deal.'
A DoH spokesman said that it was 'for PCTs and practices to decide' how to use the additional £50m investment.
A spokesman said that PCTs were given £120m to spend on GP-led health centres, but may have used other funds to provide 'additional services' at the clinics.