GPs' practice-based commissioning (PBC) involvement has passed the government's 30 per cent 'tipping point', according to a GP survey.
Dr David Colin-Thome, the government's primary care czar, said that a 30 per cent GP uptake would be 'the tipping point' to make the scheme a success, when it was first discussed in 2004 (GP, 17 December 2004).
The poll of 102 practices found that 42 per cent were already involved in PBC, either by setting up or commissioning through local schemes.
Almost two thirds have signed up for the PBC directed enhanced service, and a handful expect to make savings of several hundred thousand pounds.
However, one in 10 GPs does not wish to be involved, and 32 per cent said they would not do it this year because their PCTs would not provide them with an indicative budget.
GPC negotiator Dr Richard Vautrey welcomed the results of the survey, and said it was the hope of the GPC 'to see practices dipping their toes in the water to see what they might make'.
He felt some sympathy for the 32 per cent unable to obtain an indicative budget.
'Difficulty in getting this data is indicative of the poor information that PCTs have had in the past, and this will be the real challenge to take commissioning forward,' he said.
NHS Alliance chairman Dr Michael Dixon said that the 42 per cent PBC involvement rate at this stage was similar to his own research and that the scheme had seen 'an enormous take-off in the past six weeks'.
'GPs think that if we don't take this on, some private company will,' he said.
The survey revealed a wide array of plans that were making a range of savings.
Last week, GP reported a vasectomy scheme earning £30,000 per year for a GP in Suffolk under PBC.
A number of schemes include employing a local respiratory nurse for 11 practices in Essex, reviewing a urology patient pathway in the Thames Valley, and a practice in south-west Staffordshire that is analysing its quality data to set up an 'at risk' group of dementia patients.
In the Stockton area of Teesside, 26 practices have joined forces in a commissioning group which hopes to save up to £300,000.
Dr John Harley said there was 'no big win to achieve this, because if there is one, it has mostly already been done'.
However, he said there would be a number of small ideas that worked together, and he highlighted referral management as one area where good savings could be made.
'It's about improving the interface between GPs and consultants,' he said.
Commenting on the results of the survey, a DoH spokesman said: 'It's important to stress that PBC remains voluntary for practices, but we hope that the majority will take up the opportunity to become commissioners.'
- 42 per cent involved in PBC.
- 10 per cent never intend to take part.
- 63 per cent have signed up for a PBC enhanced service.
- 32 per cent are not expecting to receive an indicative budget this