Last year, Hillingdon, in north-west London, hit the headlines twice. Both times the publicity was unwelcome.
First, Hillingdon PCT achieved notoriety by forecasting a £65 million deficit in 2006/7, more than any other NHS organisation in England.
Then a terminally ill patient wrote up her excruciating experiences at the acute trust in Hillingdon Hospital's overworked dual-sex medical assessment unit and her sister, media figure Janet Street-Porter, published them in the Independent on Sunday.
This is not a situation where GPs can usually help. But in Hillingdon, GPs have been preparing not only to take the pressure off A&E but in the longer term ‘significantly' to cut the debts of the PCT.
GPs plan to run an urgent care centre alongside the acute trust's emergency department and to operate a GP-based referral management system.
Dr Mitch Garsin, Uxbridge GP and chairman of the Hillingdon Commissioning Confederation, a group that includes each of the 56 Hillingdon practices, said: 'We can make economies which will save the PCT enough money to contribute significantly towards restoring financial balance.'
The GPs will be running with the DoH's invitation both to commission and provide services.